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Galantamine versus risperidone treatment of neuropsychiatric symptoms in patients with probable dementia: an open randomized trial


Freund-Levi, Yvonne, Jedenius, Erik, Tysen-Bäckström, Ann Christine, Lärksäter, Marie, Wahlund, Lars-Olof, Eriksdotter, Maria


The American Journal Of Geriatric Psychiatry: Official Journal Of The American Association For Geriatric Psychiatry, Volume: 22, No.: 4, Pages.: 341-348

Year of Publication



Objective: To examine the effects of galantamine and risperidone on neuropsychiatric symptoms in dementia (NPSD) and global function.; Methods: Using a randomized, controlled and open-blind, one-center trial at an in- and outpatient clinic at a university hospital, we studied 100 adults with probable dementia and NPSD. Participants received galantamine (N = 50, target dose 24 mg) or risperidone (N = 50, target dose 1.5 mg) for 12 weeks. The primary outcome was effects on NPSD assessed by the Neuropsychiatric Inventory (NPI). Secondary measures included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Clinical Global Impression, and Simpson Angus scales. All tests were performed before and after treatment.; Results: Outcome measures were analyzed using analysis of covariance. Ninety-one patients (67% women, mean age 79 ± 7.5 years) with initial NPI score of 51.0 (± 25.8) and MMSE of 20.1 (± 4.6) completed the trial. Both galantamine and risperidone treatments resulted in improved NPSD symptoms and were equally effective in treating several NPI domains. However, risperidone showed a significant treatment advantage in the NPI domains irritation and agitation, F(1, 97) = 5.2, p = 0.02. Galantamine treatment also ameliorated cognitive functions where MMSE scores increased 2.8 points compared with baseline (95% confidence interval: 1.96-3.52). No treatment-related severe side effects occurred.; Conclusions: These results support that galantamine, with its benign safety profile, can be used as first-line treatment of NPSD symptoms, unless symptoms of irritation and agitation are prominent, where risperidone is more efficient.; Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Bibtex Citation

@article{Freund_Levi_2014, doi = {10.1016/j.jagp.2013.05.005}, url = {}, year = 2014, month = {apr}, publisher = {Elsevier {BV}}, volume = {22}, number = {4}, pages = {341--348}, author = {Yvonne Freund-Levi and Erik Jedenius and Ann Christine Tysen-Bäckström and Marie Lärksäter and Lars-Olof Wahlund and Maria Eriksdotter}, title = {Galantamine Versus Risperidone Treatment of Neuropsychiatric Symptoms in Patients with Probable Dementia: An Open Randomized Trial}, journal = {The American Journal of Geriatric Psychiatry} }


aged, aged, 80 and over, antipsychotic agents, cholinesterase inhibitors, dementia, drug therapy, female, galantamine, humans, irritable mood, male, neuropsychiatric symptoms, neuropsychological tests, npi, npsd, psychology, psychomotor agitation, risperidone, therapeutic use, treatment outcome

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Behaviour, Cognition, Prevention and/or management of co-morbidities

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime, Antipsychotics and antidepressants