Alzheimer's Drugs Double Death Risk

Experts Say Anti-Dementia Drugs Are Dangerous, Overused

(AP)  Anti-psychotic drugs commonly used to treat Alzheimer's disease may double a patient's chance of dying within a few years, suggests a new study that adds to concerns already known about such medications.

"For the vast majority of Alzheimer's patients, taking these drugs is probably not a worthwhile risk," said Clive Ballard, the paper's lead author, of the Wolfson Centre for Age-Related Diseases at King's College London.

"Would I want to take a drug that slightly reduced my aggression but doubled my risk of dying? I'm not sure I would," Ballard said.

The research was published Friday in the medical journal Lancet Neurology.

Alzheimer's disease is the most common cause of dementia and causes symptoms including aggression, delusions and hallucinations. Previous studies have shown anti-psychotic drugs, which can help control the aggression and hallucinations for a few months raise the risk of death in older patients with dementia. There are other side effects, including respiratory problems and stroke.

Ballard and colleagues followed 165 patients aged 67 to 100 years with moderate to severe Alzheimer's disease from 2001 to 2004 in Britain. Half continued taking their anti-psychotic drugs, which included Risperdal, Thorazine and Stelazine. The other half got placebos.

Of the 83 receiving drugs, 39 were dead after a year. Of the 82 taking fake pills, 27 were dead after a year. Most deaths in both groups were due to pneumonia.

After two years, 46 percent of Alzheimer's patients taking the anti-psychotics were alive, versus 71 percent of those not on the drugs. After three years, only 30 percent of patients on the drugs were alive, versus 59 percent of those not taking drugs.

In the United Kingdom and the United States, guidelines advise doctors to use anti-psychotic drugs cautiously and temporarily. But in many nursing homes in Europe and North America, up to 60 percent of patients with dementia are routinely given the drugs for one to two years.

"The drug regimen for any person with Alzheimer's needs to be personalized," said William Thies of the Alzheimer's Association in the U.S. Thies was not connected to the study. "At some points, some people will be better off with no medication."

Simon Lovestone of the Institute of Psychiatry at King's College in London said psychiatrists should try environmental or behavioral therapies instead of anti-psychotics.

Experts aren't sure how the anti-psychotics increase patients' risk of dying. But they think the drugs could be damaging to the brain and their sedative effects make patients less able to exercise and more susceptible to deadly infections.

The study was paid for by the U.K. Alzheimer's Research Trust. Ballard reported receiving grants from various pharmaceutical companies which make drugs used to treat Alzheimer's patients.

[richbear39]

SOYLENT GREEN ANYONE?

[oldpilot954]

The only ones that win in prolonging the life of a person with Alzheimers are the care facilities that take all of the family inheritance. Certainly we want to carefully consider what we give but the person is going to die within a few years. For me, staying more mentally capable until the end would be far preferable to being unable to walk, communicate, feed myself, etc. for a longer period of time.

[brainteaser2]

So what! You have an incurable disease if the available drugs provide a year or two of additional relatively normal functioning at the cost of several additional years of living in a diaper, not knowing anyone, with drool on my face I''ll take it gladly.

[k9sr4me-2009]

my mom has dementia/alzheimer''s disease and i''m her caregiver. after living with this for quite some time now, if i were to get it, i''d rather take the drug and go quickly, than linger on. it''s horrible. only those that have gone down the road i''m on can fully understand.

[rushlimpdrug]

Ahh, gee, I forgot wat i wz gna pssst.

[brannigon]

Alzheimer''s Drugs Double Death Risk? When is this going to stop! People are not lab rats! The government needs to do something about the FDA! They''re killing people; not helping them! This is insane!!!

[runningralph]

If a person can''t feed themselves, go to a toilet, or perform any useful task, and are completely out of touch with reality, what reason is there to prolong their life? I ask because I could be there myself soon. Many at my age(71)are already there.

[biomegaly]

I believe the findings are speculative at best. This is a controlled group and nearly as many patients on the placebo died as did the patients taking the antipsychotics. Also, these patients died of pneumonia per the article. As we age, it becomes increasingly more difficult to swallow. It is likely these patients developed pneumonia by aspirating (choking on thin liquids). Small particles enter the lungs causing an infection.

Families must weigh the pros and cons. As an individual in the medical field, it''s risk is valid. It is very difficult to cope at times for the families of people with Alzheimers and dementia; due to their aggitation. It''s a miracle when the drug begins to help.

[tincup356]

given time the FDA will end up poisoning most of us peddling the wishes of the pharmaceutical giants.

[lf1952]

You are missing the point here.

NO ONE says that ALL patients should get anti-psychotic meds for Alzheimer''s. Probably, VERY few should get them, and then LATE in the process and then only by clinicians specializing in Alzheimer''s. However, a trial of giving them for marked agitation/aggression (and a "trial" implies that the meds are then stopped and the behavior between the two compared) will do no harm.

Leaving patients on any medication without a good reason is always wrong. Patients simply don''t do on "auto-pilot".

Withholding medication because of a ridiculously small study is likewise wrong.

Refusing to *try* a medication that an HCP with extensive experience suggests, based on what happened to ANOTHER patient is also inappropriate. Even if you believed that this study proved something - I don''t - IF one of this class medication provides a potential benefit and no short term risk (this study does not show any short term risk) there is no reason to withhold it.

That all said, just because this study is so under-powered as to be of little help, does NOT mean it''s wrong.