Nursing home sufferers’ illness worsened by drugs used to treat
Alzheimer’s
Quetiapine, a drug
commonly used in nursing homes to treat agitation and related symptoms in
people with Alzheimer’s disease actually worsens patients’ illness, speeding
up their rate of decline significantly, according to a study in the
British Medical Journal (BMJ).
Antipsychotic drugs are
used in up to 45% of nursing homes to treat agitation, a common and
distressing symptom of dementia (a catch-all term for diseases such as
Alzheimer’s.) Researchers found that, when given a placebo as treatment for
these symptoms, patients showed little change. Yet, those patients
administered the frequently used antipsychotic drug quetiapine showed a
marked worsening in the condition with noticeable deterioration of memory
and other higher brain functions (cognitive decline).
The authors stated that
this finding was of particular significance as quetiapine had been regarded
as one of the safer of the antipsychotic drugs available. Ninety
three dementia patients across the northeast of England were looked
at over six months. Those in the study taking quetiapine experienced a
doubling in cognitive decline compared with the placebo control group.
While patients taking
rivatigmine, another antipsychotic in the trial, showed little or no
worsening of their illness, neither was there improvement in symptoms above
the placebo group. The study raised significant concern regarding the
safety of quetiapine, suggesting it cannot be considered a viable
alternative to either of the two most commonly used antipsychotic drugs for
people with dementia –
risperidone or olanzapine
– which, the authors pointed out,
themselves carry increased risk of stroke.
They argued that there
are vital implications to be derived from this study. Not only should
quetiapine not be used in place of other drugs for alleviating symptoms of
patients with dementia, the findings also underscore concerns over long term
use of antipsychotics in these patients.
SOURCE:
Ballard C, et.al. “Quetiapine and rivastigmine and cognitive decline in
Alzheimer’s disease: randomised double blind placebo controlled trial,”
BMJ, Feb 2005
