Brexpiprazole for the Treatment of Agitation in Alzheimer Dementia
RCT (n=345) found brexpiprazole (2 mg or 3 mg daily) showed a significant improvement versus placebo in agitation over 12 weeks (Cohen-Mansfield Agitation Inventory total score from baseline to week 12, least-squares mean difference, −5.32; 95% CI, −8.77 to −1.87; P=0.003).
Source:
JAMA Neurology
SPS commentary:
A related editorial discusses the current mainstay of pharmacological management of agitation with antipsychotics, but highlights the risks associated with them such as falls, fractures, rapid cognitive decline, cerebrovascular events, and mortality. It discusses brexpiprazole, an atypical antipsychotic approved in US for the treatment of schizophrenia and as an adjunctive therapy for major depression and highlights recent licensing by the FDA for the treatment of agitation due to Alzheimer Dementia. It praises the study and compares results to two previous trials investigating brexpiprazole in this cohort. It notes the excess deaths that occurred with brexpiprazole compared to placebo and advises caution when using this treatment.