Atypical antipsychotic medications have fewer side effects than traditional antipsychotic medications. Atypical antipsychotic medications have been used "off-label" to treat psychosis caused Alzheimer's disease. The term "off-label" means that the medications are not approved by the Food and Drug Administration for this use and have not gone through clinical trial to assess their effectiveness. Recent studies indicate that these medications have serious side effects and limited effectiveness when used to treat Alzheimer's disease.
Olanzapine
Olanzapine, brand name Zyprexa, has recently had a "black box" warning added addressing use of the drug in Alzheimer's patients. The warning states that the drug carries an additional risk of death while taking the drug, as well as an increased risk of stroke or mini-stroke, the National Institutes of Health reports. Olanzapine can also cause high blood sugar, known as hyperglycemia, drowsiness, dizziness, depression, weight gain and unusual behavior. More serious side effects include seizures and Parkinson's symptoms, consisting of uncontrollable movements of the face and body.
A study of 421 patients reported in the October 12, 2006, issue of the "New England Journal of Medicine" by lead author Lori Schneider of the University of California found that while olanzapine was slightly more effective than placebo in treating psychotic symptoms in Alzheimer's patients, with 32 percent showing minimal improvement compared to 21 percent of those receiving the placebo, the rate of significant side effects limited its use. Confusion, cognitive changes and other changes in mental status were more common with olanzapine than risperidone and quetiapine, the other two drugs in the study. Parkinsonism, which causes tremors and uncontrollable movements known as extrapyramidal effects, were more common in this study in patients taking this drug and risperidone.
Risperidone
Risperidone, commercially available as Risperdal, carries the same black box warning as olanzapine. Side effects are also similar. Twenty-nine percent of patients taking risperidone showed minimal improvement in the University of California study as compared to 21 percent for the placebo, a difference not considered statistically significant.
Quetiapine
Quetiapine, commercially sold as Seroquel, shares the black box warning and off-label use status of risperidone and olanzapine. Side effects are also the similar. Quetiapine may cause cataracts; patients taking the drug should have frequent eye exams, the National Institutes of Health states. In the University of California study, only 26 percent of patients showed improvement of symptoms, the lowest of the three drugs tested.
References
- "The New England Journal of Medicine"; Effectiveness of Atypical Antipsychotic Drugs in Patients With Alzheimer'sDisease: Lori Schneider, M.D.; October 12, 2006
- Medpage TODAY:Atypical Antipsychotics Get Poor Grade
- National Institutes of Health: Risperidone
- National Institutes of Health: Olanzapine
- National Institutes of Health: Quetiapine
