Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ. 2015;350: h369. https://doi.org/10.1136/bmj.h369.
Article PubMed PubMed Central Google Scholar
Cummings J, Mintzer J, Brodaty H, Sano M, Banerjee S, Devanand DP, et al. Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition. Int Psychogeriatr. 2015;27(1):7–17. https://doi.org/10.1017/S1041610214001963.
Ballard C, Corbett A, Howard R. Prescription of antipsychotics in people with dementia. Br J Psychiatry. 2014;205(1):4–5. https://doi.org/10.1192/bjp.bp.113.128710.
Reus VI, Fochtmann LJ, Eyler AE, Hilty DM, Horvitz-Lennon M, Jibson MD, et al. The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia. Focus (Am Psychiatr Publ). 2017;15(1):81–4. https://doi.org/10.1176/appi.focus.15107.
Fazio S, Pace D, Maslow K, Zimmerman S, Kallmyer B. Alzheimer’s association dementia care practice recommendations. Gerontologist. 2018;58(suppl_1):S1–9. https://doi.org/10.1093/geront/gnx182.
Lee D, Clark ED, Antonsdottir IM, Porsteinsson AP. A 2023 update on the advancements in the treatment of agitation in Alzheimer’s disease. Expert Opin Pharmacother. 2023;24(6):691–703. https://doi.org/10.1080/14656566.2023.2195539.
Administration USFaD. FDA approves first drug to treat agitation symptoms associated with dementia due to Alzheimer’s disease. 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-treat-agitation-symptoms-associated-dementia-due-alzheimers-disease. Accessed 27 Mar 2025.
Grossberg GT, Kohegyi E, Mergel V, Josiassen MK, Meulien D, Hobart M, et al. Efficacy and safety of brexpiprazole for the treatment of agitation in Alzheimer’s dementia: two 12-week, randomized, double-blind, placebo-controlled trials. Am J Geriatr Psychiatry. 2020;28(4):383–400. https://doi.org/10.1016/j.jagp.2019.09.009.
Behl S, Slomkowski M, Chen D, Chang D, Hefting N, Lee D, et al. Brexpiprazole for the treatment of agitation associated with dementia due to Alzheimer’s disease: a 12-week, active-treatment, extension trial. J Alzheimers Dis. 2024;102(2):520–9. https://doi.org/10.3233/JAD-240491.
Wang PS, Schneeweiss S, Avorn J, Fischer MA, Mogun H, Solomon DH, et al. Risk of death in elderly users of conventional vs. atypical antipsychotic medications. N Engl J Med. 2005;353(22):2335–41. https://doi.org/10.1056/NEJMoa052827.
Article PubMed CAS Google Scholar
Schneider LS, Dagerman K, Insel PS. Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. Am J Geriatr Psychiatry. 2006;14(3):191–210. https://doi.org/10.1097/01.JGP.0000200589.01396.6d.
Mok PLH, Carr MJ, Guthrie B, Morales DR, Sheikh A, Elliott RA, et al. Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study. BMJ. 2024;385: e076268. https://doi.org/10.1136/bmj-2023-076268.
Article PubMed PubMed Central CAS Google Scholar
Herrmann N, Lanctot KL. Do atypical antipsychotics cause stroke? CNS Drugs. 2005;19(2):91–103. https://doi.org/10.2165/00023210-200519020-00001.
Marinheiro G, Dantas JM, Mutarelli A, Menegaz de Almeida A, Monteiro GA, Zerlotto DS, et al. Efficacy and safety of brexpiprazole for the treatment of agitation in Alzheimer’s disease: a meta-analysis of randomized controlled trials. Neurol Sci. 2024;45(10):4679–86. https://doi.org/10.1007/s10072-024-07576-8.
Nakamura Y, Adachi J, Hirota N, Iba K, Shimizu K, Nakai M, et al. Brexpiprazole treatment for agitation in Alzheimer’s dementia: a randomized study. Alzheimers Dement. 2024;20(11):8002–11. https://doi.org/10.1002/alz.14282.
Article PubMed PubMed Central CAS Google Scholar
Aga VM. Brexpiprazole for the treatment of agitation in Alzheimer’s disease dementia: clinical uncertainties and the path forward. Am J Geriatr Psychiatry. 2025;33(3):322–9. https://doi.org/10.1016/j.jagp.2024.11.003.
Higgins JPTTJ, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions. 1st ed. New York: Wiley; 2019. https://doi.org/10.1002/9781119536604.
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372: n160. https://doi.org/10.1136/bmj.n160.
Article PubMed PubMed Central Google Scholar
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology. 1984;34(7):939–44. https://doi.org/10.1212/wnl.34.7.939.
Article PubMed CAS Google Scholar
Sterne JAC, Savovic J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366: l4898. https://doi.org/10.1136/bmj.l4898.
Koss E, Weiner M, Ernesto C, Cohen-Mansfield J, Ferris SH, Grundman M, et al. Assessing patterns of agitation in Alzheimer’s disease patients with the Cohen-Mansfield Agitation Inventory. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord. 1997;11(Suppl 2):S45–50. https://doi.org/10.1097/00002093-199700112-00007.
Busner J, Targum SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry (Edgmont). 2007;4(7):28–37.
Kaufer DI, Cummings JL, Christine D, Bray T, Castellon S, Masterman D, et al. Assessing the impact of neuropsychiatric symptoms in Alzheimer’s disease: the neuropsychiatric inventory caregiver distress scale. J Am Geriatr Soc. 1998;46(2):210–5. https://doi.org/10.1111/j.1532-5415.1998.tb02542.x.
Article PubMed CAS Google Scholar
Barnes TR. A rating scale for drug-induced akathisia. Br J Psychiatry. 1989;154:672–6. https://doi.org/10.1192/bjp.154.5.672.
Article PubMed CAS Google Scholar
Simpson GM, Angus JW. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl. 1970. https://doi.org/10.1111/j.1600-0447.1970.tb02066.x.
Veroniki AA, Jackson D, Viechtbauer W, Bender R, Bowden J, Knapp G, et al. Methods to estimate the between-study variance and its uncertainty in meta-analysis. Res Synth Methods. 2016;7(1):55–79. https://doi.org/10.1002/jrsm.1164.
IntHout J, Ioannidis JP, Borm GF. The hartung-knapp-sidik-jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard dersimonian-laird method. BMC Med Res Methodol. 2014;14:25. https://doi.org/10.1186/1471-2288-14-25.
Article PubMed PubMed Central Google Scholar
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60. https://doi.org/10.1136/bmj.327.7414.557.
Article PubMed PubMed Central Google Scholar
Rhodes KM, Turner RM, Higgins JP. Predictive distributions were developed for the extent of heterogeneity in meta-analyses of continuous outcome data. J Clin Epidemiol. 2015;68(1):52–60. https://doi.org/10.1016/j.jclinepi.2014.08.012.
Article PubMed PubMed Central Google Scholar
Rover C, Friede T. Using the bayesmeta R package for Bayesian random-effects meta-regression. Comput Methods Programs Biomed. 2023;229: 107303. https://doi.org/10.1016/j.cmpb.2022.107303.
Balduzzi S, Rücker G, Schwarzer G. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health. 2019;22(4):153–60.
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