CARBAMAZEPINE TREATMENT OF AGITATION IN NURSING-HOME PATIENTS WITH DEMENTIA - A PRELIMINARY-STUDY

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.