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Journal of Geriatric Psychiatry and Neurology, Vol. 17, No. 2, 61-67 (2004)
DOI: 10.1177/0891988704264535

Risperidone is Effective for Wandering and Disturbed Sleep/Wake Patterns in Alzheimer’s Disease

Kenichi Meguro, MD, PhD

Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan, meg{at}mail.c.tohoku.ac.jp

Mitsue Meguro, MSc

Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan

Yasuhiro Tanaka, MD

Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan

Kyoko Akanuma

Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan

Keiichiro Yamaguchi, MD, PhD

Division of Nuclear Medicine, Cyclotron Radioisotope Center, Tohoku University, Sendai, Japan

Masatoshi Itoh, MD, PhD

Division of Nuclear Medicine, Cyclotron Radioisotope Center, Tohoku University, Sendai, Japan

Behavioral and psychological symptoms of dementia (BPSD), especially aggressiveness, wandering, and sleep disturbance, are a major burden for caregivers. Daily sleep/wake patterns and wandering of institutionalized patients with Alzheimer’s disease (AD) were visually monitored, and 34 patients who manifested wandering were selected and randomly classified into 2 groups: the risperidone group and the nonrisperidone group. After an administration of low-dose risperidone for the risperidone group, the BPSD were reassessed. The binding potentials of dopamine D2 receptor for preadministration and postadministration of risperidone were assessed using positron emission tomography (PET) for 1 case. After the use of risperidone, aggressiveness and wandering were reduced and the nighttime sleeping hours were increased. The PET revealed that the binding potential of dopamine receptor was increased after administration of the drug, associated with improved sleep/wake patterns and behavioral abnormality. Possible serotonergic modulation of dopaminergic function might explain the neurobiological basis of the effect of risperidone.

Key Words: Alzheimer’s disease • risperidone • BPSD • wandering • sleep • PET


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