Cognitive performance, behavioural and psychological symptoms, and circadian rhythm disturbances in Alzheimer’s disease patients treated with quetiapine or haloperidol

Alzheimer’s Disease (AD) is characterised by cognitive decline, behavioural problems (BPSD) and sleep-wake cycle disturbances: the latter decrease the quality of life of patients and caregivers and result in earlier institutionalisation. 16 AD patients (10 women, 6 men, age:80±2 y, MMSE: 19±1) were enrolled in this 6-week, open, comparative study and randomly assigned to quetiapine or haloperidol. Before and after 4 weeks treatment, we assessed cognitive performance with CERAD, BPSD with NPI and NOSGER, and the circadian rest-activity cycle with actimetry for one week. Some cognitive functions (delayed word recall) improved with quetiapine (p<0.05). Haloperidol worsened depression scores (p<0.05) and increased abnormal motor activity as well as augmenting difficulties in self care, whereas quetiapine improved both symptoms of depression and anxiety (p<0.05). A significant fragmentation of the circadian rest-activity cycle was found after haloperidol, whereas quetiapine tended to consolidate circadian rhythm organisation. Overall, these results show a tendency for quetiapine to improve not only cognitive performance, but also BPSD and circadian rhythm disturbances, in contrast to haloperidol. (Funding: AstraZeneca)