Antipsychotics in dementia: Beyond ‘black-box’ warnings
What now? Evidence and clinical wisdom support a 5-step evaluation of psychosis and aggression.
Table 4
Atypicals in dementia: Starting and target doses
| Drug | Starting dose | Target dose |
|---|---|---|
| Aripiprazole | 2.5 to 5 mg/d | 7.5 to 12.5 mg/d |
| Olanzapine | 2.5 to 5 mg/d | 5 to 10 mg/d |
| Quetiapine | 12.5 to 25 mg/d | 50 to 200 mg/d |
| Risperidone | 0.25 to 0.5 mg/d | 0.5 to 1.5 mg/d |
| Source: Reference 23 | ||
Related resources
- Jeste DV, Blazer D, Casey D, et al. ACNP White Paper: update on use of antipsychotic drugs in elderly persons with dementia. Neuropsychopharmacology 2008;33(5):957-70.
- American Association for Geriatric Psychiatry position statement: principles of care for persons with dementia resulting from Alzheimer disease. www.aagponline.org/prof/position_caredmnalz.asp.
Drug brand names
- Alprazolam • Xanax
- Aripiprazole • Abilify
- Atenolol • Tenormin
- Buspirone • Buspar
- Carbamazepine • Tegretol
- Ciprofloxacin • Ciloxan
- Citalopram • Celexa
- Clozapine • Clozaril
- Diphenhydramine • Benadryl
- Divalproex • Depakote
- Donepezil • Aricept
- Haloperidol • Haldol
- Hydrocodone/acetaminophen • Lortab, Vicodin
- Lorazepam • Ativan
- Memantine • Namenda
- Olanzapine • Zyprexa
- Oxazepam • Serax
- Oxybutynin • Ditropan
- Paroxetine • Paxil
- Quetiapine • Seroquel
- Risperidone • Risperdal
- Rivastigmine • Exelon
- Sertraline • Zoloft
- Trazodone • Desyrel
- Ziprasidone • Geodon
Disclosure
Dr. Meeks receives research/grant support from the John A. Hartford Foundation, the Mental Health Research Foundation, NARSAD, and the U.S. Department of Health and Human Services’ Health Resources and Services Administration.
Dr. Jeste receives research/grant support from the John A. Hartford Foundation, the National Institute of Aging, and the National Institute of Mental Health. AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Company, and Janssen, L.P. provide free medications for an NIMH-funded study for which Dr. Jeste is the principal investigator.
