Posted by ed_uk on October 28, 2005, at 16:14:21
Lon Schneider, University of Southern California, Los Angeles, and colleagues conducted a meta-analysis of published and unpublished clinical trials of antipsychotic drugs in patients with Alzheimer’s disease or dementia.
A total of 3,353 patients taking either aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel) or risperidone (Risperdal), plus 1,757 taking placebo, were included.
For treatment periods of less than eight to 12 weeks, the researchers found that death occurred more frequently in patients treated with antipsychotics compared with placebo (overall odds ratio 1.54; 95 per cent confidence interval 1.06–2.23, P=0.02). They found no evidence for differential risks for individual drugs and the increased risk could only be identified when the data were combined in a meta-analysis.
The researchers estimate that the likelihood of the drugs helping rather than harming may be modest. “For every nine to 25 persons helped in these trials there possibly will be one death,” they say. “The established risks for cerebrovascular adverse events together with the present observations suggest that antipsychotic drugs should be used with care in these patients.”
They add that the effect may not be limited to atypical drugs and may be associated with haloperidol and other drugs used in elderly patients with dementia.
The authors of an accompanying editorial (ibid, p1963) say the results do not contraindicate use of antipsychotic drugs in this patient group but change the risk-benefit analysis. They should only be used when there is an identifiable risk of harm to others, the distress caused by symptoms is significant, or when other therapies have failed, they say.
poster:ed_uk
thread:572772
URL: http://www.dr-bob.org/babble/20051024/msgs/572772.html