Abstract

A Comparison of Lamotrigine or Sodium Valproate on the Efficacy in Alzheimers disease with Behavioral and Psychological Symptoms of Dementia: A Retrospective Open-Label Study Running Title: Efficacy of Anticonvulsants for BPSD

Hidenobu Suzuki and Yuichi Inoue

Aim: We compared the clinical efficacy and subsequent changes in dosages of concomitantly used psychotropic drugs with lamotrigine and sodium valproate therapy in Alzheimer’s disease (AD) with Behavioral and Psychological Symptoms on Dementia (BPSD). Methods: This study was a 16-week, retrospective, open-label study. The 45 subjects were inpatients. The outcome measures assessed were BPSD and cognitive function. BPSD was assessed using the neuropsychiatric inventory (NPI) and cognitive function was assessed using the mini-mental examination (MMSE). The changes in the dosages of concomitant psychotropic drugs were also assessed. Results: Although the mean changes from baseline NPI scores and the two NPI subscales (agitation and irritability) decreased both in the lamotrigine therapy group and in the sodium valproate therapy group, no significant difference was found between the two groups. The mean decrease in diazepam-equivalent dose from baseline was significantly greater in the lamotrigine therapy group than that in the sodium valproate therapy group (p < 0.05). Furthermore, in the sodium valproate therapy group, the occurrence rates of somnolence, body tilt, and dizziness were all 30%. Conclusions: The results of this study suggested that while the administration of lamotrigine or sodium valproate might be effective in patients with severe AD with BPSD, special attention is required when using sodium valproate on a daily basis.