A TRIAL OF BUSPIRONE FOR THE CONTROL OF DISRUPTIVE BEHAVIORS IN COMMUNITY-DWELLING PATIENTS WITH DEMENTIA

We report the results of a pilot study examining the dose-response of buspirone for the treatment of agitated and disruptive behaviors in dementia patients. Patients were identified by physician referral, chart review and caregiver response to newspaper advertisements. All subjects met NINCDS-ADRDA criteria for probable Alzheimer's disease. Twenty subjects were entered into the study, 12 completed the protocol. After a washout period, all subjects received 1 week of placebo followed by approximately 2 weeks each of buspirone 15 mg, 30 mg, 45 mg and 60 mg daily. The primary outcome measure was the total score on Reisberg's Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), which was administered at baseline, the end of the placebo phase and at the end of each dosage interval. Significant improvement in the mean score was seen at a daily dosage of 30 mg (p <X0.05 vs placebo). Significant improvement was also seen on the delusion, aggression and anxiety subscales of the BEHAVE-AD. Few side-effects were noted. These data suggest that the optimal starting dosage of buspirone for the treatment of behavioral pathology in dementia patients is 30 mg daily. Individual patients may have their best response at dosages ranging from 15 to 60 mg daily. Confirmation of these findings requires a double-blind, placebo-controlled clinical trail.