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Source: British Medical Journal Released: Wed 16-Feb-2005, 14:00 ET

Embargo expired: Thu 17-Feb-2005, 18:10 ET
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Drugs Used to Treat Alzheimer's in Nursing Homes Are Worsening Illness
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QUETIAPINE ALZHEIMERS WORSENS PATIENTS' ILLNESS
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Description

Quetiapine, a drug commonly used in nursing homes to treat agitation
and related symptoms in people with Alzheimers' disease actually
worsens patients' illness, speeding up their rate of decline
significantly, says a paper.

Headline : BMJ Press Release 18 February 2005

Quetiapine and rivastigmine and cognitive decline in Azheimer's
disease: randomised double blind placebo controlled trial BMJ Online
First

Newswise - Quetiapine, a drug commonly used in nursing homes to treat
agitation and related symptoms in people with Alzheimers' disease
actually worsens patients' illness, speeding up their rate of decline
significantly, says a paper published on bmj.com today.

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 Alzhimer's.)

Researchers found that, when given a placebo as treatment for these
symptoms, patients showed little change. But those patients given the
commonly used antipsychotic drug quetiapine showed a marked worsening
in the condition with marked deterioration of memory and other higher
brain functions (cognitive decline).

This is particularly significant as quetiapine had been regarded as one
of the safer of the antipsychotic drugs available, say the authors.

The study looked at 93 patients with dementia across the north east of
England over six months. Those in the study taking quetiapine
experienced a doubling in cognitive decline compared with the control
group who had been given placebo. Those taking another antipsychotic in
the trial, rivatigmine, showed little or no worsening of their illness
- but no improvement in symptoms above the placebo group.

There have been concerns about the safety of the two most commonly used
antipsychotic drugs in people with dementia, risperidone and
olanzapine, because of increased risk of stroke, say the authors. The
current study highlights considerable concern regarding the safety of
quetiapine, and suggest that quetipaine is not a viable alternative to
these medications.

This study has vital implications for the treatment of patients with
dementia, argue the authors. Quetiapine should not be used instead of
other drugs for alleviating their symptoms, and these findings
highlight concerns over long term use of antipsychotics in these
patients.

Click here to view full paper:
http://press.psprings.co.uk/bmj/february/alzheimers.pdf


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mary_gordon

Most people here would know quetiapine by the trade name seroquel.

Mary G.

james michael howard

I posted this at the BMJ in response to the article.

"In 1985 I suggested low DHEA could result in Alzheimer's disease.
While controversial, this hypothesis has since been supported. A case
may
be made that low DHEA is connected to AD.

While I could not find research connecting quetiapine with DHEA,
quetiapine reduces prolactin which is a direct stimulator of DHEA and
quetiapine reduces cortisol which has been interpreted to indicate
that
quetiapine shuts down the HPA axis.

I suggest the negative effects of quetiapine on individual with AD is
due to the shutdown of DHEA."

James Michael Howard