Aripiprazole for the treatment of psychotic symptoms in patients with dementia with Lewy bodies: a case series

• Published in: Neuropsychiatric disease and treatment 2019-01, Vol.15, p.543-547
• Main Authors: Sugawara Kikuchi, Yuka, Shimizu, Tetsuo
• Format: Article
• Language: English
• Subjects: Alzheimer's disease; Antipsychotics; Aripiprazole; Basal ganglia; Caregivers; Case studies; Central nervous system diseases; Cognition & reasoning; Cognitive ability; Complications and side effects; Dementia; Dementia disorders; Dosage and administration; Drug dosages; Drug therapy; Hallucinations; Lewy bodies; Lewy body disease; Movement disorders; Original Research; Patients; Psychiatry; Psychological manifestations of general diseases; Psychosis; Psychotic symptoms; Psychotropic drugs; Schizophrenia
• ISSN: 1176-6328; 1178-2021; 1178-2021
• DOI: 10.2147/NDT.S189050

The core features of dementia with Lewy bodies (DLB) are cognitive fluctuations, visual hallucinations, and parkinsonian symptoms. Although there have been several reports on the efficacy of treatments for psychotic symptoms in patients with DLB, little is known regarding the treatment effects of aripiprazole. The aim of this study was to evaluate the efficacy and safety of aripiprazole for the treatment of psychotic symptoms in patients with DLB. We employed a 10-week, open-label study design with 11 patients who met the criteria for DLB. The patients had previously experienced persistent or intermittent delusions, hallucinations, or both for at least 1 month. Aripiprazole was initiated at a low dose (3 or 6 mg/day) and titrated to higher doses at 2-week intervals or more rapidly, as needed. The Neuropsychiatric Inventory (NPI), Brief Psychiatric Rating Scale (BPRS), and Clinical Global Impression-Severity (CGI-S) were administered at baseline and 1, 2, 4, 8, and 10 weeks later. The Simpson-Angus Scale (SAS), Clinical Dementia Rating (CDR), and Mini-Mental State Examination (MMSE) Scale were evaluated at baseline and at week 10. The NPI, CGI-S, and BPRS scores were compared between the baseline and each assessment point and between each assessment point and the one before assessment point. The SAS, CDR, and MMSE scores were compared between the baseline and the end point. The mean NPI and BPRS scores improved until the fourth week; they significantly decreased at each assessment point compared to the previous one. Afterward, improvements slowed and continued without significant decrease. The median SAS scores significantly decreased at the end point compared to the baseline (