Do antipsychotics lead to cognitive impairment in dementia? A meta-analysis of randomised placebo-controlled trials

Springer Science and Business Media LLC - Tập 267 - Trang 187-198 - 2016
Alexander Wolf1, Stefan Leucht2, Frank-Gerald Pajonk2
1Department of Anaesthesiology, Intensive Care and Pain Medicine, Saarland University Medical Center, Homburg, Germany
2Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany

Tóm tắt

Behavioural and psychological symptoms in dementia (BPSD) are common and often treated with antipsychotics, which are known to have small efficacy and to cause many side effects. One potential side effect might be cognitive decline. We searched MEDLINE, Scopus, CENTRAL and www.ClincalStudyResult.org for randomized, double-blind, placebo-controlled trials using antipsychotics for treating BPSD and evaluated cognitive functioning. The studies identified were summarized in a meta-analysis with the standardized mean difference (SMD, Hedges’s g) as the effect size. Meta-regression was additionally performed to identify associated factors. Ten studies provided data on the course of cognitive functioning. The random effects model of the pooled analysis showed a not significant effect (SMD = −0.065, 95 % CI −0.186 to 0.057, I 2 = 41 %). Meta-regression revealed a significant correlation between cognitive impairment and treatment duration (R 2 = 0.78, p < 0.02) as well as baseline MMSE (R 2 = 0.92, p < 0.005). These correlations depend on only two out of ten studies and should interpret cautiously.

Tài liệu tham khảo

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