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Effects of memantine on behavioural symptoms in Alzheimer's disease patients: an analysis of the Neuropsychiatric Inventory (NPI) data of two randomised, controlled studies.
Int J Geriatr Psychiatry. 2005 May; 20(5):459-64.IJ

Abstract

INTRODUCTION

Behavioural symptoms are common in moderate to severe Alzheimer's disease (AD). We have analysed the databases of two randomised studies with regard to the effects of memantine treatment on behavioural symptoms, measured using the 12-item version of the Neuropsychiatric Inventory (NPI).

SUBJECTS

The monotherapy study (memantine only) reported by Reisberg et al. (2003) involved 252 patients with baseline MMSE total score of between 3 and 14, whereas the combination study (memantine and donepezil) reported by Tariot et al. (2004) comprised 404 patients with MMSE scores of between 5 and 14. In both studies, patients received 10 mg memantine b.i.d. or matching placebo, and lived in the community.

METHODS

For both studies NPI total and individual domains scores were analysed in the ITT population. For the monotherapy study a dichotomised analysis was performed separately for patients who had behavioural symptoms at baseline and for those without pre-existing symptoms. Furthermore, a factor analysis was used to identify any behavioural clusters within the patient population.

RESULTS

In both studies, the change in NPI total scores at endpoint was consistently in favour of memantine treatment, reaching statistical significance in the combination study (p = 0.002). Memantine treatment showed a significant beneficial effect in comparison to placebo treatment in the NPI agitation/aggression domain in both studies (p = 0.008; p = 0.001). The dichotomised analysis of the monotherapy study showed that there was significantly less agitation/aggression emerging in the memantine-treated group compared to placebo (p = 0.003). Factor analysis showed that hyperactivity accounted for 27% of the data variance.

CONCLUSIONS

Memantine has a beneficial effect on the behavioural symptoms of patients with moderate to severe AD, with the most pronounced effect on agitation/aggression.

Authors+Show Affiliations

MCSA Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, Quebec, Canada. serge.gauthier@mcgill.caNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

15852444

Citation

Gauthier, S, et al. "Effects of Memantine On Behavioural Symptoms in Alzheimer's Disease Patients: an Analysis of the Neuropsychiatric Inventory (NPI) Data of Two Randomised, Controlled Studies." International Journal of Geriatric Psychiatry, vol. 20, no. 5, 2005, pp. 459-64.
Gauthier S, Wirth Y, Möbius HJ. Effects of memantine on behavioural symptoms in Alzheimer's disease patients: an analysis of the Neuropsychiatric Inventory (NPI) data of two randomised, controlled studies. Int J Geriatr Psychiatry. 2005;20(5):459-64.
Gauthier, S., Wirth, Y., & Möbius, H. J. (2005). Effects of memantine on behavioural symptoms in Alzheimer's disease patients: an analysis of the Neuropsychiatric Inventory (NPI) data of two randomised, controlled studies. International Journal of Geriatric Psychiatry, 20(5), 459-64.
Gauthier S, Wirth Y, Möbius HJ. Effects of Memantine On Behavioural Symptoms in Alzheimer's Disease Patients: an Analysis of the Neuropsychiatric Inventory (NPI) Data of Two Randomised, Controlled Studies. Int J Geriatr Psychiatry. 2005;20(5):459-64. PubMed PMID: 15852444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of memantine on behavioural symptoms in Alzheimer's disease patients: an analysis of the Neuropsychiatric Inventory (NPI) data of two randomised, controlled studies. AU - Gauthier,S, AU - Wirth,Y, AU - Möbius,H J, PY - 2005/4/27/pubmed PY - 2005/8/30/medline PY - 2005/4/27/entrez SP - 459 EP - 64 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 20 IS - 5 N2 - INTRODUCTION: Behavioural symptoms are common in moderate to severe Alzheimer's disease (AD). We have analysed the databases of two randomised studies with regard to the effects of memantine treatment on behavioural symptoms, measured using the 12-item version of the Neuropsychiatric Inventory (NPI). SUBJECTS: The monotherapy study (memantine only) reported by Reisberg et al. (2003) involved 252 patients with baseline MMSE total score of between 3 and 14, whereas the combination study (memantine and donepezil) reported by Tariot et al. (2004) comprised 404 patients with MMSE scores of between 5 and 14. In both studies, patients received 10 mg memantine b.i.d. or matching placebo, and lived in the community. METHODS: For both studies NPI total and individual domains scores were analysed in the ITT population. For the monotherapy study a dichotomised analysis was performed separately for patients who had behavioural symptoms at baseline and for those without pre-existing symptoms. Furthermore, a factor analysis was used to identify any behavioural clusters within the patient population. RESULTS: In both studies, the change in NPI total scores at endpoint was consistently in favour of memantine treatment, reaching statistical significance in the combination study (p = 0.002). Memantine treatment showed a significant beneficial effect in comparison to placebo treatment in the NPI agitation/aggression domain in both studies (p = 0.008; p = 0.001). The dichotomised analysis of the monotherapy study showed that there was significantly less agitation/aggression emerging in the memantine-treated group compared to placebo (p = 0.003). Factor analysis showed that hyperactivity accounted for 27% of the data variance. CONCLUSIONS: Memantine has a beneficial effect on the behavioural symptoms of patients with moderate to severe AD, with the most pronounced effect on agitation/aggression. SN - 0885-6230 UR - https://www.unboundmedicine.com/medline/citation/15852444/Effects_of_memantine_on_behavioural_symptoms_in_Alzheimer's_disease_patients:_an_analysis_of_the_Neuropsychiatric_Inventory__NPI__data_of_two_randomised_controlled_studies_ DB - PRIME DP - Unbound Medicine ER -