Fukushima J. Med. Sci.,
Vol. 52, No. 2, 2006

[Case Report]

EFFECTS OF FLUVOXAMINE ON BEHAVIORAL AND PSYCHOLOGICAL
SYMPTOMS OF DEMENTIA IN ALZHEIMER'S DISEASE :
A REPORT OF THREE CASES

MASATAKE KURITA¹⁻³⁾, TADAHIRO SATO¹⁾, SATOSHI NISHINO¹⁻³⁾,
KOJI OHTOMO²⁾, HISAYOSHI SHIRAKAWA²⁾, HIROBUMI MASHIKO²⁾,
SHIN-ICHI NIWA²⁾ and NORIMICHI NAKAHATA³⁾

¹⁾Kotokukai Sato Hospital, Yamagata, 960-2156, Japan
²⁾Department of Neuropsychiatry, Fukushima Medical University School of Medicine,
Fukushima, 960-1295, Japan
³⁾Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences,
Tohoku University, Sendai, 980-8578, Japan

(Received July 21, 2006, accepted September 27, 2006)

Abstract: OBJECTIVE : To report 3 cases of severe behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD) with fluvoxamine treatment and to discuss the treatment implications for use of the drug.
      CASE SUMMARY: An 83-year-old woman was diagnosed with AD. Before treatment, she showed sudden irritation and excitement. Her BEHAVE-AD score was 40. She was started on fluvoxamine and quetiapine. Eight weeks later, she was friendly and thankful towards the staff. Her BEHAVE-AD score was 10. The second case was a 79-year-old woman diagnosed with AD. Before treatment, she attempted to leave our hospital and wandered and shouted throughout the day. Her BEHAVE-AD score was 42. She was started on fluvoxamine, and the dosage was gradually increased. Eight weeks later, the shouting and excitement disappeared almost completely. Her BEHAVE-AD score was 13. The third case was a 79-year-old man diagnosed with AD. Before treatment, we put him in a private, locked room because he was extremely agitated and violent because of delusions. His BEHAVE-AD score was 42. He was started on fluvoxamine and sodium valproate. Eight weeks later, the delusion became mild and did not affect his mood or behavior. His BEHAVE-AD score at this point was 4.
      DISCUSSION: Fluvoxamine was effective in controlling BPSD with AD. This finding shows that the pathophysiology of BPSD due to AD may occur because of a hyposerotonergic state in the brain.
      CONCLUSION: These cases show that fluvoxamine appears to be effective in the control of BPSD with AD.

Key words: Alzheimer's disease, AD; behavioral and psychological symptoms of dementia, BPSD; Behavioral Pathology in Alzheimer's Disease Rating Scale, BEHAVE-AD; fluvoxamine

栗田征武，佐藤忠宏，西野　敏，大友好司，白川久義，増子博文，丹羽真一，中畑則道

Correspondence to: Masatake Kurita, Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima City 960-1295, Japan.
E-mail: m-kurita@fmu.ac.jp