Healthy Skepticism Library item: 7306

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Publication type: news

Aggression drugs little help in Alzheimers - study
Reuters 2006 Oct 11
http://today.reuters.com/news/articleinvesting.aspx?view=CN&storyID=2006-10-12T031957Z_01_N11272733_RTRIDST_0_HEALTH-ANTIPSYCHOTICS.XML&rpc=66&type=qcna

Abstract:

Antipsychotic drugs commonly used to treat Alzheimer’s patients with delusions, aggression and other symptoms may help some patients but cause too many side effects to be truly useful, U.S. researchers reported on Wednesday.

The drugs are given to quiet agitated and hard-to-handle Alzheimer’s patients and include olanzapine, made by Eli Lilly and Co. under the brand name Zyprexa, quetiapine, made by AstraZeneca under the brand name Seroquel, and Johnson & Johnson’s risperidone, sold as Risperdal.

“The antipsychotic medications may be effective against some symptoms in Alzheimer’s patients compared to placebo, but their tendency to cause intolerable adverse side effects in this vulnerable population offsets their benefits,” said Dr. Lon Schneider of the University of Southern California, who led the study.

“Antipsychotic medications have been used extensively for Alzheimer’s patients without enough solid evidence of whether they are effective,” National Institute of Mental Health Director Dr. Thomas Insel added in a statement.

“The study has vital public health implications because it provides physicians and patients with information to more accurately weigh the medications’ benefits against their drawbacks, with the needs and unique reactions of their individual patients.”

Writing in the New England Journal of Medicine, the NIMH-funded team said it studied 421 patients with Alzheimer’s complicated by delusions, aggression, hallucinations or agitation.

Patients got either one of the three drugs or a placebo.

Ultimately, up to 85 percent of all the patients discontinued their medication, either because of adverse side effects or no improvement. That indicates the active medications did not help any better than the placebo did, Schneider said.

They did find that 26 percent to 32 percent of those taking the active medications improved, compared with 21 percent of those taking placebo.

But the antipsychotic medications also often made the patients sleepy, confused and caused weight gain.

Up to three-quarters of all Alzheimer’s patients suffer delusions or aggression, Schneider said, making it hard to care for them.

“It was a surprise, in that the expert opinion which drove this study was that these drugs are particularly useful in treating these difficult symptoms.”

An estimated 4.5 million people in the United States alone suffer from Alzheimer’s, the most common cause of dementia. There is no cure.