Tiapride in Treatment of Behavioral Disturbancesin Geriatric Long-term Patients: Open Multicentre Study Evaluating Safetyand Efficacy

Overview

Behavioural disturbances such as agitation, psychomotor restlessness, irri-tability, disruption or abusive behaviour are common clinical problems in 50- 70 % of nursing home residents. As causal treatment is only rarely available,symptomatic treatment with psychotropics is recommended to relieve symp-toms. Among other drugs atypic neuroleptic tiapride has been found effecti-ve and safe in clinical trials performed on smaller samples of otherwisehealthy patients.The main objective of this study was to confirm the therapeutic efficacy andsafety of tiapride (Tiapridal ® ) in a larger sample of elderly subjects withbehaviour problems under conditions of everyday clinical practice.Altogether 485 long-term care residents with an acute onset of agitation wereincluded in this prospective, multicentre, open drug trial. The average agewas 81.6 yrs, 72.6% were females. The recommended dosage of tiapride was300 mg/day, duration of treatment 2 weeks. The behavioural symptoms ratedwith Brief Agitation Rating Scales (BARS) improved and the BARS score wasdecreasing continuously after 2, 7 and 14 days of treatment from 33.5 to 16.4points (p < 0.001). A positive therapeutic effect - as rated by investigators -was found in 89.1% of treated patients with no difference between genderand age groups. Only 12 (2.5%) patients stopped treatment for lack of thera-peutic effect. Adverse events occurred only in 3 (0.6%) patients.Tiapride, a substituted benzamide derivative and selective dopamine D2 re-ceptor antagonist proved effective and safe for symptomatic treatment ofbehavioural problems in geriatric long-term care.

Key words:
behavioral disturbances, elderly, pharmacotherapy, geriatric andlong-term care.