Antipsychotics for Alzheimer’s up death risk: study

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Antipsychotic drugs prescribed to treat aggression in older Alzheimer’s patients appear to significantly raise their risk of dying prematurely, British researchers said Friday.

The results from the first long-term study on the effect of the medicines on people with Alzheimer’s highlights the need to seek less harmful treatments for many of these patients, Clive Ballard of King’s College London and colleagues said.

During their three-year study, men and women given a placebo were 42 percent less likely to die than people who remained on their antipsychotic medication, the study published in the journal Lancet Neurology found.

"Our data add further serious safety concerns about the long-term use of antipsychotics in this population, and clinicians should certainly try to replace antipsychotics with safer management approaches,” the researchers wrote.

Alzheimer’s is an incurable brain disease that worsens over time and is the most common form of dementia, affecting 26 million people globally, according to the Alzheimer’s association.

Antipsychotic drugs have increasingly been used to treat the personality changes and aggression often associated with the disease, but the new findings suggest for many they may not be worth the risk.

“Our opinion is that there is still an important but limited place for atypical antipsychotics in the treatment of severe (symptoms), particularly aggression,” the researchers wrote.

“However, the accumulating safety concerns ... emphasize the urgent need to end unnecessary and prolonged prescribing.”

In the study carried out between 2001 and 2004, 128 patients aged from 67 to 100 years were assigned to continue their antipsychotic treatment for 12 months or switched to a placebo.

The drugs included the generic treatments thioridazine, chlorpromazine, haloperidol, trifluoperazine and Johnson & Johnson’s Risperdal, or risperidone.

No one at Johnson & Johnson was immediately available for comment.

After one year, slightly more people in the antipsychotic group had died but after 36 months, survival in the placebo group was 59 percent compared to 30 percent among the people on the drugs.

Other researchers noted that, because antipsychotic drugs are also linked to higher risk of stroke and a decline in brain function, the latest findings underscore the need to find other ways to help such patients.

“This work highlights the pressing need to develop and evaluate alternative pharmacological and non-pharmacological treatments for behavioral symptoms in dementia,” Richard Perry, a neurologist at Imperial College Healthcare in London, said in a statement.

LONDON (Reuters)

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