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Allopurinol for the treatment of aggressive behaviour in patients with dementia

Lara, Diogo R.a; Cruz, Matheus R.S.b; Xavier, Flaviob; Souza, Diogo O.c; Moriguchi, Emilio H.b

International Clinical Psychopharmacology: January 2003 - Volume 18 - Issue 1 - p 53-55
Case Reports

Aggressive behaviour is commonly observed in patients with dementia, and current pharmacological treatments are still deficient in terms of efficacy and tolerability. Allopurinol is an inhibitor of the enzyme xanthine oxidase, with previously suggested anti-aggressive effects. After successful treatment of aggression in two patients, we performed a case-series study with allopurinol 300 mg a day orally for 6 weeks (increasing 300 mg every 2 weeks if the response was less than 50%) in six patients with dementia associated with prominent aggressive behaviour who failed to respond to two previous treatment strategies. Five patients were considerably responsive to allopurinol (four with 300 mg within 2 weeks and one with 600 mg), apparently without side-effects, which is in accordance with its well-established safety and tolerability profile. The observed therapeutic effect of allopurinol might be due to the inhibition of the enzyme xanthine oxidase, possibly decreasing production of oxigen-free radicals or promoting the accumulation of purines. Controlled studies are warranted to confirm these preliminary observations.

aDepartamento de Ciências Fisiológicas, Faculdade de Biociências, PUCRS

bInstituto de Geriatria e Gerontologia, PUCRS

cDepartamento de Bioquímica, Instituto de Ciências Básicas da Saúde, UFRGS, Porto Alegre, Brazil

Correspondence and requests for reprints to Diogo Rizzato Lara, Faculdade de Biociências, PUCRS, Av. Ipiranga, 6681 – Pd 12A, Porto Alegre, RS, 90619-900, Brazil

Tel: +55 51 332 03545; fax: +55 51 332 03612; e-mail:

Received 1 July 2002 Accepted 4 September 2002

© 2003 Lippincott Williams & Wilkins, Inc.