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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
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Schneider, University of Southern California, Los Angeles, and colleagues conducted a meta-analysis of published and unpublished clinical trials of antipsychotic drugs in patients with Alzheimer’s disease or dementia.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.
Posted by CareBear04 on October 28, 2005, at 16:36:02
In reply to Increased risk of death with atypicals, posted by ed_uk on October 28, 2005, at 16:14:21
yikes! that's pretty scary. i've had many doctors who dispense antipsychotics, atypicals especially, like candy. i don't know if i meet the criteria for antipsychotic use, but i'm apparently on the highest dose of abilify. eek!
Posted by SLS on October 28, 2005, at 18:18:28
In reply to Increased risk of death with atypicals, posted by ed_uk on October 28, 2005, at 16:14:21
This is old news. For some reason, there seems to be a greater risk of CVA with neuroleptics when used to treat people with Alzheimers Dementia.
- Scott
Posted by ed_uk on October 28, 2005, at 18:35:58
In reply to Increased risk of death - Alzheimers only., posted by SLS on October 28, 2005, at 18:18:28
It's not really surprising. The weight gain, hyperglycemia, diabetes, abnormal lipid profile........ weight gain > hypertension etc. With some APs, hyperprolactinemia might also play a role, hyperprolactinemia has been linked to various forms of thrombo-embolic disease. I doubt the risk of stroke (CVA) is confined to patients with Alzheimer's disease.
APs have been linked to CVA, deep vein thrombosis, pulmonary embolism, cardiac arrhythmias, sudden cardiac death, seizures, blood disorders and neuroleptic malignant syndrome.
~ed
Posted by SLS on October 28, 2005, at 19:02:02
In reply to Re: Increased risk of death - Alzheimers only., posted by ed_uk on October 28, 2005, at 18:35:58
The stuff I read was quite specific in its statistical quantification of an increased risk of stroke when using Risperdal to treat Alzheimers compared to non-Alzheimers patients. I would not be too quick to globalize this effect beyond that which was reported.
- Scott
Posted by ed_uk on October 28, 2005, at 19:19:09
In reply to Re: Increased risk of death - Alzheimers only. » ed_uk, posted by SLS on October 28, 2005, at 19:02:02
It's still a concern. I think it needs further investigation.
How are you feeling on dexa?
~ed
Posted by Phillipa on October 28, 2005, at 19:39:43
In reply to Re: Increased risk of death - Alzheimers only. » SLS, posted by ed_uk on October 28, 2005, at 19:19:09
All the more reason to find a pdoc who prescribes valium. Love PJ O
Posted by Cecilia on October 29, 2005, at 4:01:12
In reply to Re: Increased risk of death - Alzheimers only. » ed_uk, posted by Phillipa on October 28, 2005, at 19:39:43
Believe me, if I get Alzheimers, the faster death comes the better. Cecilia
Posted by ed_uk on October 29, 2005, at 14:30:11
In reply to Re: Increased risk of death - Alzheimers only., posted by Cecilia on October 29, 2005, at 4:01:12
>Believe me, if I get Alzheimers, the faster death comes the better.
I feel the same way about myself. It's a horrendous illness.
~ed
This is the end of the thread.
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