Atypical Antipsychotics Offer Little Help for Alzheimer’s Patients

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The news continues to get worse for the makers of newer atypical antipsychotic drugs. A new study published in the New England Journal of Medicine found “no significant differences” between the effectiveness of the drugs and that of placebos in the treatment of Alzheimer’s patients who suffer from psychosis, aggression, and agitation. However, the potential for dangerous side effects caused by costly atypical antipsychotics has led the researchers to question whether or not these drugs should be used at all in the treatment of Alzheimer’s.

“Adverse effects offset advantages in the efficacy of atypical antipsychotic drugs for the treatment of psychosis, aggression, or agitation in patients with Alzheimer’s disease,” the NEJM study concludes. In the 42-site, double-blind, placebo-controlled trial of 421 randomly assigned outpatients, researchers tested the effectiveness of three popular atypical antipsychotics: Eli Lilly’s Zyprexa, AstraZenaca’s Seroquel, and Janssen Pharmaceutical’s Risperdal. Side effects of these drugs include sleepiness, weight gain, and a state of confusion.

Dr. Thomas R. Insel, director of the National Institute of Mental Health, told the New York Times, “What this study shows is that these drugs are clearly not the answer; they may be helpful for a minority of patients, but we need to come up with better medications.” (The NIMH financed the study.) He called for a “new generation of drugs” to treat Alzheimer’s patients who’ve developed personality disorders or suffer from dementia.

Dr. Claudia Kawas predicted in the Los Angeles Times that many doctors would continue prescribing these drugs due to a lack of alternatives. “The behavioral problems of Alzheimer’s disease are huge,” she notes, but she added that “if given in high enough doses to do any good, there are going to be side effects.” Although the FDA never approved these drugs for treatment of Alzheimer’s, they have been quite commonly prescribed in that fashion–to the tune of $2 billion a year.

Only last week, a study published in the Archives of General Psychology questioned the effectiveness of atypical antipsychotics in the treatment of schizophrenia–the ailment for which it was initially developed. The more-expensive atypical antipsychotics (also known as second-generation antipsychotics or SGAs) have not been shown to have any clinical advantage when compared to typical or first-generation antipsychotics (FGAs).

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