“We thought overall the drugs would show their effectiveness,” explains Lon Schneider, professor of psychiatry, neurology and gerontology at the Keck School of Medicine of the University of Southern California (USC). “The answer is yes, they are somewhat effective, but overall the efficacy is offset by adverse events that resulted in discontinuing the medication. 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.”
Almost 3⁄4 of all Alzheimer’s patients suffer delusions or aggression, says Schneider, which makes their care particularly difficult. The study’s 421 participants at 42 sites nationwide all had Alzheimer’s disease and were experiencing delusions, hallucinations, aggression or agitation that disrupted their daily functioning.
“The findings here look at the time to discontinuation for the antipsychotics versus the placebo, and that time difference reflects the overall effectiveness of the medication. By that measure, the medications were not better than placebo,” he explains. “Patients on the medications were more likely to discontinue because of the side effects, offsetting the efficacy.”
Side effects from the three antipsychotic medications – olanzapine, quetiapine, and risperidone – ranged from sedation, weight gain and confusion to worsening psychosis.
Almost a quarter of those taking olanzapine quit because of adverse events, as did 18% on risperidone and 16% on quetiapine. Those on all three medications were significantly more likely to discontinue treatment than those who received a placebo.
Ultimately between 77 to 85% of study participants discontinued their medication, either because of adverse side effects or no improvement.
MEDICA.de; Source: University of Southern California