Sedatives link to early death
Updated on 31 March 2007
Many Alzheimer's patients are dying earlier because of sedatives they are being prescribed, according to research.
Results from a five-year project, funded by the Alzheimer's Research Trust, found that the drugs were linked with a significant increase in long-term mortality - with patients dying on average six months earlier.
The investigation by King's College London researchers found that the sedatives, known as neuroleptics, were associated with a significant deterioration in verbal fluency and cognitive function, and that neuroleptic treatment had no benefit to patients with the mildest symptoms.
Significantly, up to 45% of people with Alzheimer's disease residing in nursing homes are prescribed neuroleptics as a treatment for behavioural symptoms such as aggression.
Professor Clive Ballard, professor of age-related disorders at the university, said: "It is very clear that even over a six month period of treatment, there is no benefit of neuroleptics in treating the behaviour in people with Alzheimer's disease when the symptoms are mild - specifically when a measure of behavioural disturbance known as the Neuropsychiatric Inventory Score is equal to or less than 14.
"For people with more severe behavioural symptoms, balancing the potential benefits against increased mortality and other adverse events is more difficult, but this study provides an important evidence base to inform this decision-making process."
Rebecca Wood, chief executive of the Alzheimer's Research Trust, said: "These results are deeply troubling and highlight the urgent need to develop better treatments."
The study examined 165 people with Alzheimer's disease living in nursing homes in Oxfordshire, Newcastle, Edinburgh and London. They had been taking neuroleptic drugs for at least three months and took part in a long-term randomised double-blind placebo controlled neuroleptic withdrawal trial.
The neuroleptics in the study were thioridazine (Melleril), chlorpromazine (Largactil), haloperidol (Serenace), trifluoperazine (Stelazine) and risperidone (Risperdal).
An additional follow up was completed a minimum of 12 months after initial enrolment to determine the impact of continuing or discontinuing neuroleptics on mortality. The differences in survival were particularly striking at 24 months (78% v 55%), 36 months (62% v 35%) and 42 months (60% v 25%).
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