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Effect of second-generation antipsychotics on caregiver burden in Alzheimer's disease
Mohamed S, Rosenheck R, Lyketsos CG, Kaczynski R, Sultzer DL, Schneider LS.. The Journal of clinical psychiatry, 2011-09-06
Topic: Amyloid, tau and blood-test diagnosis
Background Alzheimer's disease (AD) imposes a severe burden upon patients and their caregivers. Severity of psychiatric symptoms and behavioral disturbances is an important determinant of caregivers' experience of burden. These symptoms may be improved with atypical antipsychotic treatment. Objective Data from the Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer's Disease (CATIE-AD) trial were used to evaluate the effect of atypical antipsychotics versus placebo on the experiences of caregivers of outpatients with AD. Method We compared the effect of atypical antipsychotic drugs (olanzapine, risperidone, or quetiapine-considered together as a group) versus placebo on the experiences of caregivers of AD outpatients (diagnosed according to DSM-IV-TR). We also evaluated whether improvement in patients' psychiatric and behavioral symptoms mediated the relationship between drug treatment and caregiver burden. The CATIE-AD trial, conducted from April 2001 through November 2004, included outpatients (mean age = 77.9 years [SD = 7.5 years]) in usual care settings and assessed treatment effectiveness over a 9-month period at 42 US sites. In a set of secondary analyses, data from CATIE-AD participants who had at least 1 postbaseline outcome assessment and data from their caregivers were examined in an intention-to-treat (ITT) analysis (N = 361). A phase 1-only analysis was conducted including only observations while patients were receiving the initially randomized drug (N = 153). The Burden Interview, the Beck Depression Inventory, and the Neuropsychiatric Inventory (NPI) Caregiver Distress Scale were used to evaluate caregiver burden. Results In both ITT and phase 1-only analyses, caregivers of patients treated with second-generation antipsychotics scored significantly lower than caregivers of patients receiving placebo on both the Burden Interview (P = .0090) and the NPI Caregiver Distress Scale (P = .0209). These differences appeared to have been mediated by lower levels of agitation, hostility, and psychotic distortions. Conclusion In AD patients with symptoms of psychosis, agitation, or aggressive behavior, medications can have a small but significant impact on caregiver burden.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Mohamed, S., Rosenheck, R., Lyketsos, C. G., Kaczynski, R., Sultzer, D. L., & Schneider, L. S. (2012). Effect of second-generation antipsychotics on caregiver burden in Alzheimer's disease. The Journal of clinical psychiatry. https://doi.org/10.4088/jcp.10m06574
Vancouver
Mohamed S, Rosenheck R, Lyketsos CG, Kaczynski R, Sultzer DL, Schneider LS. Effect of second-generation antipsychotics on caregiver burden in Alzheimer's disease. The Journal of clinical psychiatry. 2012. doi:10.4088/jcp.10m06574. PMID: 21939611.
BibTeX
@article{mohamed2012-21939611,
author = {Mohamed, S. and Rosenheck, R. and Lyketsos, C. G. and Kaczynski, R. and Sultzer, D. L. and Schneider, L. S.},
title = {{Effect of second-generation antipsychotics on caregiver burden in Alzheimer's disease}},
journal = {The Journal of clinical psychiatry},
year = {2012},
doi = {10.4088/jcp.10m06574},
pmid = {21939611},
url = {https://doi.org/10.4088/jcp.10m06574}
}
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Key findings
- Objective Data from the Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer's Disease (CATIE-AD) trial were used to evaluate the effect of atypical antipsychotics versus placebo on the experiences of caregivers of outpatients with AD.
- Method We compared the effect of atypical antipsychotic drugs (olanzapine, risperidone, or quetiapine-considered together as a group) versus placebo on the experiences of caregivers of AD outpatients (diagnosed according to DSM-IV-TR).
- Results In both ITT and phase 1-only analyses, caregivers of patients treated with second-generation antipsychotics scored significantly lower than caregivers of patients receiving placebo on both the Burden Interview (P = .0090) and the NPI Caregiver Distress Scale (P = .0209).
- Conclusion In AD patients with symptoms of psychosis, agitation, or aggressive behavior, medications can have a small but significant impact on caregiver burden.
Why it matters
This analysis of the CATIE-AD trial examined whether atypical antipsychotics (olanzapine, risperidone, or quetiapine) affected caregiver burden in Alzheimer's disease. The available text does not report the results, so no conclusion about their effect on caregivers can be drawn here.
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Study details
- Study designclinical trial
- Participants361
- Evidence strengthHigh
How this study scored 59/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Journal of clinical psychiatry) |
| Journal's citation record | 2 / 4 | The Journal of Clinical Psychiatry: journal h-index 248 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 361 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 3 / 7 | Cited 25 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.6 citations a year over 16 year(s) since 2012 |
| Impact for its field and year | 2 / 6 | Cited 1.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Lon S. S. Schneider: h-index 87 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Yale University: institution h-index 1,927 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21939611) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 59 / 100 | — |
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