Pn. Tariot et al., CARBAMAZEPINE TREATMENT OF AGITATION IN NURSING-HOME PATIENTS WITH DEMENTIA - A PRELIMINARY-STUDY, Journal of the American Geriatrics Society, 42(11), 1994, pp. 1160-1166
OBJECTIVE: To determine the effects of carbamazepine versus placebo on
ratings of behavior in agitated nursing home patients with dementia.
DESIGN: Nonrandomized, placebo-controlled, crossover trial conducted i
n 25 patients in two nursing homes. INTERVENTION: Carbamazepine and pl
acebo were administered during two 5-week periods separated by a 2-wee
k washout. The carbamazepine dose was determined for each patient by a
nonblinded physician who did not participate in ratings (modal dose 3
00 mg/day). MEASUREMENTS: The primary outcome measures were Brief Psyc
hiatric Rating Scale scores and Clinical Global Impression of Change,
rated by blind observers. Secondary measures of behavior, adversity, c
ognition, and functional status were also included. MAIN RESULTS: Medi
an total Brief Psychiatric Rating Scale score decreased 7 points on ca
rbamazepine versus 3 on placebo (P = 0.03). Sixteen subjects were rate
d as improved globally on carbamazepine versus four on placebo (P = 0.
001). Secondary measures of behavior showed similar changes at signifi
cant or suggestive (P < 0.10) levels. One subject developed carbamazep
ine-induced ties, and one died with a pneumonia. There was minimal oth
er adversity. CONCLUSION: This preliminary study suggests that carbama
zepine in low doses can reduce agitated behaviors in some patients, wi
th limited adversity resulting. Further research is required to confir
m and extend this finding before it can be considered routine clinical
practice.