Risperidone for the Treatment of Dementia-Related Psychosis: A Systematic Review and Meta-Analysis.

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY Dementia and Geriatric Cognitive Disorders Pub Date : 2024-09-27 DOI:10.1159/000540689

Guanghua Zhou, Suna Yin, Shubao Zhang, Fang Hao, Lin Ma

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Abstract

Introduction: Risperidone is one of the atypical antipsychotics that has been used for the treatment of dementia-related psychosis (DRP). However, the findings concerning its efficacy and safety in DRP are contradictory.

Methods: We conducted a systematic review and meta-analysis to address the effects of risperidone on the alleviation of DRP. We searched Medline via PubMed, Scopus, Web of Science, Google Scholar, and PsychINFO from the inception until May 2024. Appropriate statistical tests were used to test the study hypothesis.

Results: The study included 17 articles and 2,311 patients with DRP. Risperidone alleviated DRP with a standardized mean difference (SMD) of 0.355 (95% CI: 0.170-0.541, p = 0.000). The impact of treatment was positively associated with treatment duration (slope p = 0.038) and dose (slope p = 0.000). Six studies (n = 354) reported the data for the effects of risperidone on cognitive function. Analysis showed that risperidone treatment deteriorated cognitive function in DRP patients with an SMD of -0.185 (95% CI: -0.349 to -0.020, p = 0.028). The mean effect size was 0.36 with a 95% CI of 0.17-0.54. However, the true effect size in 95% of all comparable populations fell in the interval of -0.37 to 1.08. This revealed a high heterogeneity among the included publications as the prediction interval showed a wider range of expected treatment effects than CI.

Conclusion: Our meta-analysis provides evidence for the effectiveness of risperidone in the management of DRP. However, because of safety concerns and high data heterogeneity, risperidone use should be individualized for each patient.

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利培酮治疗痴呆相关性精神病：系统回顾与元分析》。

简介利培酮是一种非典型抗精神病药物，一直被用于治疗痴呆相关性精神病（DRP）。然而，有关利培酮对痴呆相关精神病的疗效和安全性的研究结果却相互矛盾：我们进行了一项系统性回顾和荟萃分析，以探讨利培酮对缓解痴呆相关精神病的效果。我们通过PubMed、Scopus、Web of Science、Google Scholar和PsychINFO检索了从开始到2024年5月的Medline。我们使用了适当的统计检验来验证研究假设：研究共收录了17篇文章和2311名DRP患者。利培酮缓解了DRP，标准化平均差（SMD）为0.355（95%CI，0.170至0.541，P=0.000）。治疗效果与治疗时间（斜率 p=0.038）和剂量（斜率 p=0.000）呈正相关。六项研究（n=354）报告了利培酮对认知功能影响的数据。分析显示，利培酮治疗会使DRP患者的认知功能恶化，SMD为-0.185（95%CI，-0.349至-0.020，P=0.028）。平均效应大小为 0.36，95% CI 为 0.17 至 0.54。然而，在所有可比人群中，95% 的真实效应大小介于 -0.37 至 1.08 之间。由于预测区间显示的预期治疗效果范围比CI更广，这表明所纳入的出版物之间存在很大的异质性：我们的荟萃分析为利培酮治疗DRP的有效性提供了证据。结论：我们的荟萃分析为利培酮治疗DRP的有效性提供了证据，但由于安全性问题和高度的数据异质性，利培酮的使用应根据每位患者的具体情况而定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dementia and Geriatric Cognitive Disorders 医学-精神病学

CiteScore

4.70

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： As a unique forum devoted exclusively to the study of cognitive dysfunction, ''Dementia and Geriatric Cognitive Disorders'' concentrates on Alzheimer’s and Parkinson’s disease, Huntington’s chorea and other neurodegenerative diseases. The journal draws from diverse related research disciplines such as psychogeriatrics, neuropsychology, clinical neurology, morphology, physiology, genetic molecular biology, pathology, biochemistry, immunology, pharmacology and pharmaceutics. Strong emphasis is placed on the publication of research findings from animal studies which are complemented by clinical and therapeutic experience to give an overall appreciation of the field.