A TRIAL OF BUSPIRONE FOR THE CONTROL OF DISRUPTIVE BEHAVIORS IN COMMUNITY-DWELLING PATIENTS WITH DEMENTIA

We report the results of a pilot study examining the dose-response of buspirone for the treatment of agitated and disruptive behaviors in de mentia patients. Patients were identified by physician referral, chart review and caregiver response to newspaper advertisements. All subjec ts met NINCDS-ADRDA criteria for probable Alzheimer's disease. Twenty subjects were entered into the study, 12 completed the protocol. After a washout period, all subjects received 1 week of placebo followed by approximately 2 weeks each of buspirone 15 mg, 30 mg, 45 mg and 60 mg daily. The primary outcome measure was the total score on Reisberg's Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), which was administered at baseline, the end of the placebo phase and a t the end of each dosage interval. Significant improvement in the mean score was seen at a daily dosage of 30 mg (p <X0.05 vs placebo). Sign ificant improvement was also seen on the delusion, aggression and anxi ety subscales of the BEHAVE-AD. Few side-effects were noted. These dat a suggest that the optimal starting dosage of buspirone for the treatm ent of behavioral pathology in dementia patients is 30 mg daily. Indiv idual patients may have their best response at dosages ranging from 15 to 60 mg daily. Confirmation of these findings requires a double-blin d, placebo-controlled clinical trail.