Clinical Symptom Responses to Atypical Antipsychotic Medications in Alzheimer’s Disease: Phase 1 Outcomes From the CATIE-AD Effectiveness Trial
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OBJECTIVE: The study measured the effects of atypical antipsychotics on psychiatric and behavioral symptoms in patients with Alzheimer's disease and psychosis or agitated behavior. METHOD: The Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer's Disease (CATIE-AD) Alzheimer's disease effectiveness study included 421 outpatients with Alzheimer's disease and psychosis or agitated/aggressive behavior. Patients were assigned randomly to masked, flexible-dose treatment with olanzapine, quetiapine, risperidone, or placebo for up to 36 weeks. Patients could be randomly reassigned to a different medication at the clinician's discretion, which ended phase 1. Psychiatric and behavioral symptoms, functioning, cognition, care needs, and quality of life were measured at regular intervals. RESULTS: In relation to placebo, the last observation in phase 1 showed greater improvement with olanzapine or risperidone on the Neuropsychiatric Inventory total score, risperidone on the Clinical Global Impression of Changes, olanzapine and risperidone on the Brief Psychiatric Rating Scale (BPRS) hostile suspiciousness factor, and risperidone on the BPRS psychosis factor. There was worsening with olanzapine on the BPRS withdrawn depression factor. Among patients continuing phase 1 treatment at 12 weeks, there were no significant differences between antipsychotics and placebo on cognition, functioning, care needs, or quality of life, except for worsened functioning with olanzapine compared to placebo. CONCLUSION: In this descriptive analysis of outpatients with Alzheimer's disease in usual care settings, some clinical symptoms improved with atypical antipsychotics. Antipsychotics may be more effective for particular symptoms, such as anger, aggression, and paranoid ideas. They do not appear to improve functioning, care needs, or quality of life.
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A sub-analysis of CATIE-AD data indicated that atypical antipsychotics may be more effective for particular symptoms such as anger, aggression, and paranoid ideas.
“A sub-analysis of CATIE-AD data indicated that atypical antipsychotics may be more effective for particular symptoms such as anger, aggression, and paranoid ideas.112”
From Assessment and management of behavioral and psychological symptoms of dementia (2015) · cites this paper as [112]
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Cites
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“The symptoms had to have been rated at least moderate in severity on the Brief Psychiatric Rating Scale (BPRS) conceptual disorganization, suspiciousness, or hallucinatory behavior item (21) or had to have occurred at least weekly with moderate severity or greater on the delusion, hallucination, agitation, or aberrant…”
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- Authors
- Sultzer, D. L., Davis, S. M., Tariot, P. N., Dagerman, K. S., Lebowitz, B. D., Lyketsos, C. G., Rosenheck, R. A., Hsiao, J. K., Lieberman, J. A., Schneider, L. S., & CATIE-AD Study Group
- Affiliations
- University of California, Los Angeles (US)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2008-07
- Volume
- 165
- Issue
- 7
- Pages
- 844-854
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC2714365
- OpenAlex
- W2125346945
- Cited by
- 321
- References
- 4
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 9 · 2023: 8 · 2022: 21 · 2021: 10 · 2020: 21 · 2019: 18 · 2018: 15 · 2017: 21 · 2016: 20 · 2015: 19 · 2014: 21 · 2013: 15 · 2012: 23
- FWCI
- 20.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01mh90001-21-0-0)
- National Institute of Mental Health (N01 MH090001, N01 MH-9001)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- Alzheimer's disease, atypical antipsychotics, psychosis, agitation, olanzapine, risperidone, quetiapine, neuropsychiatric symptoms, aggression, paranoia, quality of life, cognitive function, care needs
- MeSH terms
- Quetiapine Fumarate, Olanzapine, Activities of Daily Living, Aged, Aggression, Alzheimer Disease, Benzodiazepines, Cognition Disorders, Dibenzothiazepines, Female, Humans, Male, Neuropsychological Tests, Brief Psychiatric Rating Scale, Psychomotor Agitation, Psychotic Disorders, Quality of Life, Surveys and Questionnaires, Antipsychotic Agents, Risperidone
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