Effectiveness of Atypical Antipsychotic Drugs in Patients with Alzheimer’s Disease

2018 ◽  
Author(s):  
Adam P. Mecca ◽  
Rajesh R. Tampi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Side Effects ◽  
Adverse Events ◽  
Atypical Antipsychotic ◽  
Clinical Case ◽  
Atypical Antipsychotics ◽  
Antipsychotic Drugs ◽  
Multicenter Trial ◽  
Antipsychotic Treatment

This chapter provides a summary of the Clinical Antipsychotic Trials of Intervention Effectiveness—Alzheimer’s disease (CATIE-AD), a multicenter trial that investigated whether atypical antipsychotics are an effective treatment for psychosis, aggression, or agitation in outpatients with Alzheimer’s disease. The chapter briefly reviews the study design, as well as implications and limitations. A relevant clinical case concludes the chapter. In summary, atypical antipsychotic use for up to 36 weeks did not lead to clinical improvement based on time to discontinuation, or symptom reduction. Risk of discontinuation due to adverse events and side-effects with worse with antipsychotic treatment compared to placebo. In patients with psychosis, agitation, or aggression due to Alzheimer’s disease, the efficacy of atypical antipsychotics is questionable and their use comes with considerable risks of side effects and adverse events.

Assessment and Management of Antipsychotic-Induced Adverse Events

1998 ◽  
Vol 43 (1_suppl) ◽  
pp. 15S-20S ◽  
Author(s):  
Leonardo Cortese ◽  
Emmanuelle Pourcher-Bouchard ◽  
Richard Williams
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Adverse Events ◽  
Atypical Antipsychotics ◽  
Antipsychotic Drugs ◽  
Dosage Reduction ◽  
Antipsychotic Agents ◽  
Patient Acceptance ◽  
Antipsychotic Treatment ◽  
Antipsychotic Medications

Objective: To review and discuss the spectrum of adverse events caused by antipsychotic agents that can directly influence the outcome of treatment by interfering with patient acceptance of and adherence to therapy. Method: The adverse effects of traditional and second-generation antipsychotic medications were discussed during a series of clinical workshops attended by psychiatrists from across Canada. The various adverse effects of antipsychotic drugs as well as their assessment and management are reviewed. Results: Simple techniques for assessing adverse effects such as extrapyrimidal symptoms (EPS) are described. In some cases, adverse effects can be managed by dosage reduction and/or the use of adjunctive therapies such as antiparkinsonian agents and benzodiazepines. However, in some patients dose reduction carries the risk of symptom reemergence, while the commonly used adjunctive medications are associated with adverse effects of their own. Conclusions: Treatment-related side effects often require a reduction in dosage or a change in medication. Proper management can help encourage patient compliance and improve the outcome of antipsychotic treatment. The availability of the newer atypical antipsychotics offers another alternative, because they are associated with a much lower incidence of antipsychotic-induced side effects.

scholarly journals 416 - Risk of Mortality Associated with Antipsychotics in Alzheimer's Disease

2020 ◽  
Vol 32 (S1) ◽  
pp. 132-132
Author(s):  
Liliana P. Ferreira ◽  
Núria Santos ◽  
Nuno Fernandes ◽  
Carla Ferreira
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Adverse Events ◽  
Mortality Risk ◽  
Antipsychotic Treatment ◽  
Serious Adverse Events ◽  
Risk Of Death ◽  
Mesh Terms ◽  
Risk Of Mortality ◽  
Increased Risk

Objectives: Alzheimer's disease (AD) is the most common cause of dementia and it is associated with increased mortality. The use of antipsychotics is common among the elderly, especially in those with dementia. Evidence suggests an increased risk of mortality associated with antipsychotic use. Despite the short-term benefit of antipsychotic treatment to reduce the behavioral and psychological symptoms of dementia, it increases the risk of mortality in patients with AD. Our aim is to discuss the findings from the literature about risk of mortality associated with the use of antipsychotics in AD.Methods: We searched Internet databases indexed at MEDLINE using following MeSH terms: "Antipsychotic Agents" AND "Alzheimer Disease" OR "Dementia" AND "Mortality" and selected articles published in the last 5 years.Results: Antipsychotics are widely used in the pharmacological treatment of agitation and aggression in elderly patients with AD, but their benefit is limited. Serious adverse events associated with antipsychotics include increased risk of death. The risk of mortality is associated with both typical and atypical antipsychotics. Antipsychotic polypharmacy is associated with a higher mortality risk than monotherapy and should be avoided. The mortality risk increases after the first few days of treatment, gradually reducing but continues to increase after two years of treatment. Haloperidol is associated with a higher mortality risk and quetiapine with a lower risk than risperidone.Conclusions: If the use of antipsychotics is considered necessary, the lowest effective dose should be chosen and the duration should be limited because the mortality risk remains high with long-term use. The risk / benefit should be considered when choosing the antipsychotic. Further studies on the efficacy and risk of adverse events with antipsychotics are needed for a better choice of treatment and adequate monitoring with risk reduction.

scholarly journals Alzheimer’s disease with an early debut

2019 ◽  
pp. 10-16
Author(s):  
N. N. Koberskaya ◽  
N. A. Kovalchuk
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Side Effects ◽  
Early Onset ◽  
Clinical Case ◽  
Limited Spectrum

The article reviews a clinical case of Alzheimer’s disease (AD) with early onset. This case study shows current approaches to the diagnosis of this form of AD and the management of this group of patients. It is reasonable to use Acathinol memantin in patients with early onset of AD. The drug is characterized by a minimal number of side effects and a limited spectrum of contraindications.

Risk of Death with Atypical Antipsychotic Medications for Dementia

2018 ◽  
Author(s):  
Adam P. Mecca ◽  
Rajesh R. Tampi
Keyword(s):  
Side Effects ◽  
Atypical Antipsychotic ◽  
Odds Ratio ◽  
Clinical Case ◽  
Atypical Antipsychotics ◽  
Meta Analysis ◽  
Antipsychotic Medications ◽  
Risk Of Death ◽  
Increased Risk ◽  
Atypical Antipsychotic Medications

This chapter provides a summary of a landmark meta-analysis that investigated the risks of atypical antipsychotic use to treat psychosis, aggression, or agitation in patients with dementia. The chapter briefly reviews the study design, as well as implications and limitations. A relevant clinical case concludes the chapter. In summary, atypical antipsychotic use for 6 to 26 weeks was associated with increased risk of death (Odds Ratio of 1.54 for antipsychotic vs placebo). There were no differences in risk between individual medications, disease severity, indication for antipsychotic, or treatment setting. In patients with psychosis, agitation, or aggression due to dementia, the efficacy of atypical antipsychotics is questionable and their use comes with considerable risks of side effects and adverse events.

scholarly journals Effectiveness of Atypical Antipsychotic Drugs in Patients with Alzheimer's Disease

2006 ◽  
Vol 355 (15) ◽  
pp. 1525-1538 ◽  
Author(s):  
Lon S. Schneider ◽  
Pierre N. Tariot ◽  
Karen S. Dagerman ◽  
Sonia M. Davis ◽  
John K. Hsiao ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Atypical Antipsychotic ◽  
Antipsychotic Drugs ◽  
Atypical Antipsychotic Drugs
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