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Randomized Controlled Trial
. 2009 Sep;17(9):744-51.
doi: 10.1097/JGP.0b013e3181ab8c61.

Prazosin for the treatment of behavioral symptoms in patients with Alzheimer disease with agitation and aggression

Lucy Y Wang  1 , Jane B Shofer, Kirsten Rohde, Kim L Hart, David J Hoff, Yun H McFall, Murray A Raskind, Elaine R Peskind
Affiliations
Randomized Controlled Trial

Prazosin for the treatment of behavioral symptoms in patients with Alzheimer disease with agitation and aggression

Lucy Y Wang et al. Am J Geriatr Psychiatry. 2009 Sep.

Abstract

Objectives: Agitation/aggression in Alzheimer disease (AD) is a major cause of patient distress, caregiver burden, and institutionalization. Enhanced behavioral responsiveness to central nervous system norepinephrine (NE) release may contribute to the pathophysiology of agitation/aggression in AD. Prazosin, a nonsedating generic medication used for hypertension and benign prostatic hypertrophy, antagonizes NE effects at brain postsynaptic alpha-1 adrenoreceptors. This pilot study examined the efficacy and tolerability of prazosin for behavioral symptoms in patients with agitation/aggression in AD.

Design: Double-blind, placebo controlled, parallel group study.

Setting: A university AD center and a nursing home in Seattle, WA.

Participants: Twenty-two nursing home and community-dwelling participants with agitation/aggression and probable or possible AD (mean age: 80.6 +/- 11.2).

Intervention: Randomization to placebo (N = 11) or prazosin (N = 11). Medication was initiated at 1 mg/day and increased up to 6 mg/day using a flexible dosing algorithm.

Measurements: The Brief Psychiatric Rating Scale (BPRS) and Neuropsychiatric Inventory (NPI) at Weeks 1, 2, 4, 6, and 8. The Clinical Global Impression of Change (CGIC) at Week 8.

Results: Participants taking prazosin (mean dose: 5.7 +/- 0.9 mg/day) had greater improvements than those taking placebo (mean dose: 5.6 +/- 1.2 mg/day) on the NPI (mean change: -19 +/- 21 versus -2 +/- 15, chi = 6.32, df = 1, p = 0.012) and BPRS (mean change: -9 +/- 9 versus -3 +/- 5, chi = 4.42, df = 1, p = 0.036) based on linear mixed effects models and the CGIC (mean: 2.6 +/- 1.0 versus 4.5 +/- 1.6, z = 2.57, p = 0.011 [Mann-Whitney test]). Adverse effects and blood pressure changes were similar between prazosin and placebo groups.

Conclusion: Prazosin was well tolerated and improved behavioral symptoms in patients with agitation/aggression in AD.

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References

    1. Cohen-Mansfield J, Marx MS, Rosenthal AS. A description of agitation in a nursing home. J Gerontol. 1989;44:M77–84. - PubMed
    1. Selbaek G, Kirkevold O, Engedal K. The course of psychiatric and behavioral symptoms and the use of psychotropic medication in patients with dementia in Norwegian nursing homes--a 12-month follow-up study. Am J Geriatr Psychiatry. 2008;16:528–536. - PubMed
    1. Swearer JM, Drachman DA, O’Donnell BF, et al. Troublesome and disruptive behaviors in dementia. Relationships to diagnosis and disease severity. J Am Geriatr Soc. 1988;36:784–790. - PubMed
    1. Borson S, Liptzin B, Nininger J, et al. Psychiatry and the nursing home. Am J Psychiatry. 1987;144:1412–1418. - PubMed
    1. Rabins PV, Mace NL, Lucas MJ. The impact of dementia on the family. JAMA. 1982;248:333–335. - PubMed

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