EFFECT OF CARBAMAZEPINE ON AGITATION IN ALZHEIMERS INPATIENTS REFRACTORY TO NEUROLEPTICS

Background: Agitation in Alzheimer's disease remains a principal probl em in the clinical management of elderly patients. Neuroleptic medicat ion appears to have modest efficacy in controlling behavioral symptoms in dementia patients. Carbamazepine has been reported to decrease agi tation associated with various psychiatric disorders and to reduce neu roleptic side effects. Method: In an open prospective study, the effec ts of carbamazepine on agitation, hostility, and uncooperativeness wer e investigated in 15 severely demented Alzheimer's inpatients who had failed to respond to prior treatment with neuroleptics. Depending on c linical efficacy and tolerability of carbamazepine treatment, concomit ant medication with haloperidol was initiated, Severity of psychopatho logic symptoms was assessed by the Brief Psychiatric Rating Scale duri ng the study period of 4 weeks. Results: In 2 subjects, carbamazepine treatment was discontinued because of leukopenia and allergic reaction s. A significant improvement in factor scores activation and hostility was observed after 4 weeks. Ten patients received concomitant medicat ion with haloperidol. Conclusion: Carbamazepine may be effective in tr eating agitation in severely demented Alzheimer's inpatients refractor y to neuroleptic medication alone. The combination of carbamazepine an d haloperidol seems to be promising in clinical management of elderly Alzheimer's patients.