Drug for agitation can worsen dementia

The antipsychotic drug Seroquel does not relieve agitation in elderly demented patients, and is actually associated with more rapid mental decline, investigators report.

Antipsychotic drugs are often prescribed for agitated patients with dementia, Dr. Clive Ballard at King's College London and his associates note in the British Medical Journal. Seroquel (technically known as quetiapine) is believed to cause fewer side effects than other antipsychotic agents.

Also, some studies have also suggested that drugs called cholinesterase inhibitors may be an effective treatment for agitation.

Ballard's group treated 80 nursing home residents who probably had Alzheimer's disease and agitation with quetiapine or the cholinesterase inhibitor Exelon (rivastigmine) or an inactive placebo.

The team found no differences in agitation scores at the beginning of the study or 26 weeks later in any of the groups.

However, compared with placebo, quetiapine was associated with a 15-point decline in cognitive function between the start of the study and 26 weeks later. There was no significant difference between rivastigmine and placebo at either time point.

The findings "highlight concerns regarding the long-term use of antipsychotics in these patients," Ballard's group concludes, and says Seroquel should not be used.

SOURCE: British Medical Journal, Online First edition, February 18, 2005.