Study Questions Benefits of Neuroleptics for People with Alzheimer's
> 4/1/2008 10:45:28 AM

Many individuals with Alzheimer's disease (AD) struggle with aggression, agitation, or psychosis, neuropsychiatric symptoms that commonly accompany dementia. In these instances, they are often prescribed antipsychotic medications, or neuroleptics, but these powerful medications come with potentially devastating side effects. Stroke, infections, and neurological symptoms resembling Parkinson's disease can be caused by short-term use, and long-term use can lead to further cognitive decline. In a study appearing in the Public Library of Science (PLoS) Medicine, British researchers provide evidence that long-term usage of neuroleptics may not be beneficial for many individuals with AD.

The study involved 165 subjects with AD who had already been taking neuroleptics for at least three months. The subjects were randomly assigned to  one of two conditions: to either continue with their current treatment or begin taking a placebo. They were evaluated at six and 12 months on a number of measures of dementia, and these assessments revealed few differences between those taking neuroleptics and those taking a placebo. Additionally, those who were assigned to the placebo group did not experience any adverse effects in cognitive functioning as a result of discontinuing their medication.

While the researchers found no statistically significant differences between the two groups in regards to cognitive decline and parkinsonism, they did discover some important differences between the two groups. Subjects taking a placebo had higher scores on tests of verbal fluency, an indication that those taking neuroleptics experienced more deterioration in this area. But in terms of neuropsychiatric symptoms, subjects taking neuroleptics did appear to gain some advantages that those taking the placebo did not. Further analysis revealed an association between neuroleptic use and fewer neuropsychiatric symptoms in subjects who had displayed severe neuropsychiatric symptoms at the study's start. Although this result was not statistically significant, the researchers view it as an indication that neuroleptics may help some individuals with severe behaviors associated with dementia.

When dealing with neuroleptics, the researchers stressed the importance of assessing both the risks and benefits involved. Their study, which was the first to examine neuroleptic use in individuals with dementia over the course of a year, indicates that these drugs may be an important treatment option for some, providing relief to affected individuals and their loved ones, but that these benefits may not extend to many others. The researchers emphasize that these medications should not be used as first-line forms of treatment and call for further study into safe and effective treatment options for individuals with AD. Treatment is crucial, and continued research will likely provide more insight into the appropriate uses for existing medications and lead the way toward new forms of treatment.

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