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The Times, UK


February 18, 2005

Alzheimer's drug is found to speed up mental decline
By Nigel Hawkes

TWO drugs often prescribed for dementia are ineffective and one actually speeds mental decline, a study has shown.
Quetiapine (sold as Seroquel) and rivastigmine (Exelon) are prescribed to nearly half the patients with dementia in residential homes in Britain, often for long periods. Patients are given the drugs to control behavioural changes such as agitation, which are disturbing to them and make them more difficult to look after.

But a trial in Newcastle has suggested that the drugs are ineffective and, in the case of quetiapine, accelerate the progress of the disease. The trial, funded by the Alzheimer’s Research Trust, involved 93 people with Alzheimer’s living in care homes in Newcastle. It was led by Clive Ballard, of the Institute of Psychiatry at King’s College London. The patients were treated with quetiapine, rivastigmine or a placebo pill. Neither of the groups given the active drugs showed any benefit in their agitation symptoms over six months. Those given quetiapine showed a much more rapid decline in mental capacities. A report published in the British Medical Journal says that it should not be used to treat such patients.

The results will affect medical practice because in March last year the Committee on Safety of Medicines said that the drugs risperidone and olanzapine should not be prescribed for dementia because of an increased risk of stroke.

Quetiapine was an alternative, but is now in question. Professor Ballard said: “This research shows that quetiapine does not help with the agitation experienced by some patients and that it accelerates cognitive decline.”

Rebecca Wood, chief executive of Alzheimer’s Research Trust, said: “Research is severely underfunded and we desperately need to do more towards finding effective treatments for both the symptoms and underlying disease.”

A Department of Health spokesman said last night: “In March 2004 the Committee on Safety of Medicines advised that two antipsychotic drugs, Risperidone and Olanzapine, should be used in the treatment of dementia because of an increased risk of a stroke.”

Antidepressants do not increase the risk of suicide, three studies suggest. They may, however, increase suicidal thoughts and attempts at suicide.
This comes after controversy on the safety of selective serotonin reuptake inhibitors such as GlaxoSmithKline’s Seroxat. It has been accused of concealing data about suicidal thoughts among teenagers taking Seroxat and is being investigated by the Medicines and Healthcare Products Regulatory Agency.


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