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Patterns of Change in the Treatment of Psychiatric Symptoms in Patients With Probable Alzheimer's Disease From 1983 to 2000

Received August 8, 2001; revised October 29, 2001; accepted November 14, 2001. From the Alzheimer's Disease Research Center and the Department of Psychiatry (all authors) and the Department of Neurology (O.L.L., J.T.B., D.I.K., S.T.D.), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Address correspondence to Dr. Lopez, Neuropsychology Research Program, 3501 Forbes Avenue, Suite 830, Pittsburgh, PA 15213. E-mail: Lopezol{at}msx.upmc.edu

The authors examined the pattern of use of psychiatric medication as prescribed by community physicians in 1,155 patients with probable Alzheimer's disease (AD) referred to the Alzheimer's Disease Research Center of Pittsburgh between April 1983 and July 2000. The use of antidepressants and of sedatives, hypnotics, and anxiolytics (SHA) increased over time, while the use of antipsychotics decreased. The increased use of antidepressants and decreased use of antipsychotics may reflect the growing evidence that newer antidepressants (e.g., selective serotonin reuptake inhibitors) can be used to treat not only mood-related disorders, but also abnormal behavior (e.g., aggression, agitation) and sleep disorders in AD. Although the use of SHA has a proven deleterious effect on patients with AD, their use has increased over the past two decades.

Key Words: Alzheimer's Disease • Psychiatric Symptoms • Psychopharmacology

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