Atypical antipsychotics in Alzheimer’s disease investigated
Side effects of atypical antipsychotic drugs may limit any advantages they offer when treating psychosis, aggression and agitation in Alzheimer's disease patients, a study published this week suggests (New England
Journal of Medicine 2006;355:1525).
In a double-blind trial of 421 patients, investigators found no significant
differences in the time to discontinuation of treatment for any reason — including
lack of efficacy — between groups of patients given olanzapine,
quetiapine, risperidone or placebo.
Overall, treatment was discontinued due to intolerability, adverse events
or death in 24 per cent of patients taking olanzapine, 16 per cent of
those taking quetiapine, 18 per cent of those taking risperidone and
5 per cent of those taking placebo (P=0.009, overall comparison).
The authors say that their “findings suggest that there is no large
clinical benefit of treatment with atypical antipsychotic medicines”.
Joan Kelly, senior clinical pharmacist at Lothian memory treatment service,
pointed out that the Committee on Safety of Medicines recommends that
risperidone and olanzapine should not be used for elderly patients with
dementia because of the increased
risk of stroke (PJ, 13 March 2004,
p307).
“We do use amisulpride, sulpride and quetiapine for dementia patients
as an unlicenced indication,” she said, “but there is not
very much evidence to support them.” |
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