Anti-Psychotics Little Help for Alzheimer's Sufferers

Anti-Psychotics Little Help for Alzheimer's Sufferers

(October 10, 2006) -- Anti-psychotic drugs widely used to treat symptoms of Alzheimer's disease are no more effective than dummy pills because intolerable side effects outweigh any benefits, according to a large study out Thursday. The drugs can help some, but overall, patients who took placebos benefited just as much as those on the three anti-psychotic medicines, says Lon Schneider, a geriatric psychiatrist at the University of Southern California Keck School of Medicine in Los Angeles. He led the study, reported in The New England Journal of Medicine.

Schneider estimates the drugs, called atypical anti-psychotics, are taken by more than half of Alzheimer's patients at some time to treat aggression, delusions and hallucinations, although the medicines aren't approved by the Food and Drug Administration to treat these symptoms in Alzheimer's patients.

"We don't recommend using Seroquel (one of the anti-psychotics) for psychosis, aggression or agitation in Alzheimer's patients," says Hugo Perez, spokesman for AstraZeneca, maker of the drug.

The study is the first comparing how three drugs — Zyprexa, Seroquel and Risperdal — stack up against dummy pills. The 421 patients were randomized to get one of the drugs or a placebo and stayed on their assigned pills for an average of eight weeks.

Among the serious side effects of the drugs: confusion, sleepiness, tremors and muscle stiffness.

"The message is not that nobody should get the drugs," Schneider says, "but they should be given to patients who are carefully monitored for improvements and adverse effects."

The results "are disappointing because we'd hoped we would see some benefit for Alzheimer's patients in this first big study not funded by the drug industry," says Kaycee Sink of Wake Forest University in Winston-Salem, N.C. "These behavioral problems are so hard to manage that caregivers often feel desperate."

The Food and Drug Administration last year put a black box, its most severe safety warning, on atypical anti-psychotics, saying the drugs increased premature deaths in older patients with dementia. The drugs also carry a warning about increased risk of diabetes.

Data show the black box didn't affect prescribing, says Bill Thies of the Alzheimer's Association. "These are serious problems, and we don't have great alternatives."

"Too often, these anti-psychotics get overused or misused," says neurologist John Morris, director of the Alzheimer's Disease Research Center at Washington University in St. Louis.

"These drugs should be the last line of therapy, and they're for short-term use," he says.

By Marilyn Elias
Source: USA Today

Last updated: 10/06

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Anti-Psychotics Little Help for Alzheimer's Sufferers