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Efficacy and Tolerability of Carbamazepine for Agitation and Aggression in Dementia
Abstract
Objective The efficacy, safety, and tolerability of carbamazepine in the treatment of agitation and aggression associated with dementia were assessed. Method In a 6-week, randomized, multisite, parallel-group study of 51 nursing home patients with agitation and dementia, individualized doses of carbamazepine were compared with placebo. Except for a physician monitor and a pharmacist, all participants were blind to treatment. The primary outcome measures were the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) global improvement rating. Secondary measures included measures of behavior, aggression, cognition, functional status, staff time, safety, and tolerability. Intent-to-treat analysis was performed. Results The modal carbamazepine dose at 6 weeks was 300 mg/day, and a mean serum level of 5.3 micrograms/ml was achieved. The study was terminated after a planned interim analysis showed that carbamazepine provided more benefit than did placebo. Over 6 weeks the mean total BPRS score decreased 7.7 points for the carbamazepine group and 0.9 for the placebo group, and the weekly scores showed a gradual divergence between the two groups. CGI ratings showed global improvement in 77% of the patients taking carbamazepine and 21% of those taking placebo. Secondary analyses confirmed that the positive changes were due to decreased agitation and aggression. The drug was generally well tolerated, and no change in cognition or functional status occurred. The per…
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“Two small trials of carbamazepine (n=51 and n=21) of less than six weeks’ duration showed some benefit for agitation and global clinical outcomes.143 144”
From Assessment and management of behavioral and psychological symptoms of dementia (2015) · cites this paper as [143]
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Metadata
- Authors
- Tariot, P. N., Erb, R., Podgorski, C. A., Cox, C., Patel, S., Jakimovich, L., & Irvine, C.
- Affiliations
- University of Rochester Medicine (US)
- Venue
- American Journal of Psychiatry
- Published
- 1998-01-01
- Volume
- 155
- Issue
- 1
- Pages
- 54-61
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2140320787
- Semantic Scholar
- c3da70c064f129607116262314bf832944063d1a
- Cited by
- 422
- References
- 27
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 8 · 2023: 3 · 2022: 38 · 2021: 10 · 2020: 8 · 2019: 12 · 2018: 14 · 2017: 14 · 2016: 8 · 2015: 8 · 2014: 12 · 2013: 10 · 2012: 12
- FWCI
- 13.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 08665, AG-10463, P60AG010463, P30AG008665)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Keywords
- carbamazepine, dementia, agitation, aggression, nursing home residents, antipsychotic efficacy, drug tolerability, safety, Brief Psychiatric Rating Scale, Clinical Global Impression Scale, staff time, individualized dosing
- MeSH terms
- Aged, Aged, 80 and over, Aggression, Alzheimer Disease, Carbamazepine, Dementia, Drug Administration Schedule, Female, Humans, Male, Nursing Homes, Placebos, Psychiatric Status Rating Scales, Psychomotor Agitation, Dementia, Vascular, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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