Anticonvulsants for behavioral and psychological symptoms in dementia: protocol for a systematic review

Systematic Reviews

Cecilia Cotton¹  Jennifer Tung²  Howard An³  John W. Williams⁴  Joanne Man-Wai Ho⁵  Sophiya Benjamin⁶  Stephanie Sanger⁷ 

[1] 0000 0000 8644 1405, grid.46078.3d, University of Waterloo, Waterloo, ON, Canada;0000 0004 0416 4440, grid.413277.4, Grand River Hospital, Kitchener, ON, Canada;0000 0004 0459 7334, grid.417293.a, Toxicology, Trillium Health Partners - Credit Valley Hospital, Mississauga, ON, Canada;0000 0004 1936 7961, grid.26009.3d, Duke University and the Durham Veteran Affairs Medical Center, Durham, NC, USA;0000 0004 1936 8227, grid.25073.33, Department of Medicine, McMaster University, Hamilton, ON, Canada;grid.498777.2, Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada;0000 0004 1936 8227, grid.25073.33, Department of Psychiatry & Behavioral Neurosciences, McMaster University, 10b Victoria St S, N2G 1C5, Kitchener, ON, Canada;0000 0004 1936 8227, grid.25073.33, McMaster University, Hamilton, ON, Canada;

关键词: Dementia;    Major neurocognitive disorder;    Agitation;    Behavioral and psychological symptoms;    Neuropsychiatric symptoms;    Anticonvulsants;   

DOI  :  10.1186/s13643-019-1025-5

来源: publisher

【 摘 要 】

BackgroundBehavioral and psychological symptoms of dementia (BPSD) are present in a majority of patients with dementia contributing to increased morbidity, health care costs, and caregiver burden. While there are no United States Food and Drug Administration (FDA)-approved medications for these symptoms, off-label use of medications such as antipsychotics have been shown to have significant adverse effects including increased mortality. The goal of this review is to examine the efficacy and safety of anticonvulsants in the treatment of BPSD.MethodsWe will systematically search for randomized trials of anticonvulsants compared to placebo or other treatments such as antidepressants and antipsychotics from the following sources: The Cochrane Library, MEDLINE (OVID SP) in Process and Other Non-Indexed Citations (latest version), EMBASE, clinicalTrials.gov, and the WHO Clinical Trials Registry. The studies will be limited to those published in English but the study location can be worldwide. We will include studies pertaining to individuals with dementia and symptoms of BPSD. The primary outcomes will be behavioral change as measured by validated scales and secondary outcomes will include caregiver burden, quality of life, placement in long term care facility, serious adverse effects, and treatment discontinuation due to adverse effects. Two sets of reviewers will independently screen select and extract data. We will narratively describe the major findings and conclusions from individual studies. Patients who are prescribed antiepileptic drugs (AEDs) for other indications, including seizures, will be excluded. Outcomes of interest will include a change in a validated scale that measures BPSD, serious adverse events, and caregiver quality of life outcomes. If the data are found to be appropriate for a meta-analysis, we will use a random effects model to compute summary estimates of treatment effects.DiscussionThis is a protocol for a systematic review addressing the anticonvulsant group of medications as a whole, and as such, our results will inform current clinical practice in the use of anticonvulsants for BPSD. It will also help clinicians and policy makers compare the efficacy of anticonvulsants compared to antidepressants and antipsychotics as well as identify areas which will need further study.Systematic review registrationPROSPERO CRD42017079826

【 授权许可】

CC BY