Olanzapine for Psychotic and Behavioral Disturbances in Alzheimer Disease

OBJECTIVE: To evaluate the efficacy and safety of olanzapine for the treatment of psychotic and behavioral disturbances in Alzheimer disease. DATA SOURCES: MEDLINE (1966–January 2003) and Science Citation Index searches were performed. Key search terms included olanzapine, Alzheimer(s), and dementia. DATA SYNTHESIS: Four trials of olanzapine and subsequent post hoc analyses were reviewed. Three trials found a benefit associated with olanzapine use, but a fourth trial did not. CONCLUSIONS: Olanzapine appears to be effective in treating psychotic and behavioral disturbances associated with Alzheimer disease. However, the most appropriate dose remains to be determined. The benefit of olanzapine therapy must be weighed against the adverse effect profiles of olanzapine and alternative treatment options.