Risperidone for the Treatment of Dementia-Related Psychosis: A Systematic Review and Meta-Analysis

Abstract Background Risperidone is one of the atypical antipsychotics that has been used for the treatment of dementia-related psychosis (DRP). However, the findings concerning its efficacy and safety in DRP are contradictory. Methods We conducted a systematic review and meta-analysis to address the effects of risperidone on the alleviation of DRP. We searched Medline via PubMed, Scopus, Web of Science, Google Scholar, and PsychINFO from the inception until March 2023. Appropriate statistical tests were used to test the study hypothesis. Results The study included 17 articles and 2311 patients with DRP. Risperidone alleviated DRP with a standardized mean difference (SMD) of 0.355 (95%CI, 0.170 to 0.541, p = 0.000). The impact of treatment was positively associated with treatment duration (slope p = 0.038) and dose (slope p = 0.000). Six studies (n = 354) reported the data for the effects of risperidone on cognitive function. Analysis showed that risperidone treatment deteriorated cognitive function in DRP patients with an SMD of -0.185 (95%CI, -0.349 to -0.020, p = 0.028). The heterogeneity of the data was found to be high. Conclusions Our meta-analysis provides evidence for the effectiveness of risperidone in the management of DRP. However, because of safety concerns and high data heterogeneity, its use should be individualized for each patient.