Off-Label Use of Atypical Antipsychotics: An Update
Summary of Benefits: Dementia
Atypical antipsychotics, as a class, improve behavioral symptoms of dementia, although effect sizes are small in magnitude. This conclusion is supported with high strength of evidence.
When examined individually, some, but not all, atypical antipsychotics demonstrate statistically significant differences from placebo for some outcomes. Aripiprazole and olanzapine improve scores on agitation subscales but not psychosis scores. The evidence for aripiprazole is low strength and for olanzapine it is moderate strength. Risperidone is superior to placebo on both agitation and psychosis subscales, a conclusion supported by high strength of evidence. The evidence for quetiapine is mixed and insufficient to permit conclusions.
Keywords: antipsychotics | atypical antipsychotics | off-label | second generation | dementia | aripiprazole | olanzapine | quetiapine | risperidone | psychosis | agitation
- Maglione M, Ruelaz Maher A, Hu J, et al. Off-Label Use of Atypical Antipsychotics: An Update. Comparative Effectiveness Review No. 43 (Prepared by the Southern California RAND Evidence-based Practice Center under Contract No. HHSA 290-2007-10062-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11(12)-EHC087-EF. Available at www.effectivehealthcare.ahrq.gov/offlabelantipsych.cfm.
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