ScienceCache
Vol. 178
July 22, 2004
MEDICATION HELPS QUELL THE AGITATION OF DEMENTIA
Doctors are reporting some success in treating one of the most troubling
symptoms of dementias such as Alzheimer’s disease. A drug commonly
used to treat schizophrenia and other psychotic disorders appears effective
at reducing actions like screaming at or slapping caregivers – agitated
behaviors that occur in as many as half of patients. The work, led by
Alzheimer’s expert Pierre Tariot, was presented this morning at
the 9th International Conference on Alzheimer’s Disease and Related
Disorders in Philadelphia. The medication tested in the study, quetiapine,
was effective at treating agitation, but with fewer side effects than
other medicines that doctors turn to now. “All the drugs used currently,
including quetiapine, have drawbacks,” says Tariot. “There
is no ideal solution. For each patient you have to weigh the benefit
of the drug against the potential cost in terms of side effects.” In
a 10-week study of 333 people in nursing homes, quetiapine, a newer type
of medication known as an “atypical antipsychotic,” reduced
agitated behaviors about 20 percent more often than a placebo did and
showed no evidence of causing serious side effects such as strokes.
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WEB CHAT TO FOCUS ON NEW ALZHEIMER’S STUDY RESULTS
New research about a potential treatment for the agitation that many
patients with dementia experience will be discussed in a web chat tomorrow.
The chat will focus on the research results detailed above. The results
of the study were chosen by the Alzheimer’s Association, which
sponsors the meeting, as one of the most newsworthy findings presented
at the conference. Tariot will discuss the care of patients with Alzheimer’s
and other forms of dementia directly with caregivers and others interested
in learning more tomorrow (Friday, July 23), from 2:30 to 3:15 p.m. Eastern
Time. The problem of dealing with loved ones affected by dementia is
dealt with by millions of people in the United States alone. “One
of the most stressing and vexing changes in behavior in patients with
dementia is agitation, which occurs in about half of patients at some
point in their illness,” says Tariot. “This behavior can
be terrifying to the family and is one of the major reasons many families
end up placing their loved ones in nursing homes.”
The Chat
STUDY COMPARES INITIAL TREATMENTS FOR PARKINSON’S DISEASE
In a study published this week in the Archives of Neurology, the Parkinson
Study Group reported that both levodopa and pramipexole are good options
for the initial treatment of the disease, though each has its own strengths
and weaknesses. For decades levodopa was the standard treatment for
almost all new patients, but now, additional medicines known as dopamine
agonists
are available. Parkinson’s patients have long faced a dilemma:
Effective treatment of the disease eventually causes complications so
severe that they can be worse than the disease itself. Now, in a four-year
study of 301 people with Parkinson’s disease, doctors found that
patients treated initially with pramipexole instead of levodopa had fewer
debilitating complications, including fewer involuntary movements and
less wearing off of the medication. But patients treated initially with
levodopa had less sleepiness and other side effects, and the medicine
was more effective at controlling the motor symptoms of Parkinson’s
disease. “Levodopa and pramipexole both appear to be reasonable
options as initial dopaminergic therapy for Parkinson’s disease,
but are associated with different profiles of efficacy and adverse effects”,
says neurologist Ira Shoulson, principal investigator of the study. “However,
further study is needed to assess the longer-term outcomes and cost-effectiveness
of these treatments”. The results extend the team’s earlier
findings, reported in 2000 in the Journal of the American Medical Association.
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