A drug used to relieve agitation may accelerate memory loss.
THE QUESTION Nursing homes sometimes medicate people with Alzheimer's to control the agitation that can accompany the disease. What effect might these drugs have?
THIS STUDY compared two drugs thought to help agitated dementia patients. Ninety-three people institutionalized with Alzheimer's and agitation were randomly assigned to take quetiapine (Seroquel, an antipsychotic), rivastigmine (Exelon, a cholinesterase inhibitor) or a placebo daily. After 26 weeks, tests of their emotional state showed that, on average, the agitation level of those who took the drugs was no better than those on the placebo. However, people who took quetiapine showed a greater loss of memory and cognitive functioning than those in the other groups.
WHO MAY BE AFFECTED BY THESE FINDINGS? People with Alzheimer's, especially those living in a care facility.
CAVEATS The study sample was not large. Also, the authors suggested that the modest improvements seen in those who took the placebo might be due to the extra interaction that results from participating in a study.
BOTTOM LINE Family members of people with Alzheimer's may want to talk with a doctor about options others than quetiapine for treating agitation.
FIND THIS STUDY Feb. 18 online edition of the British Medical Journal; abstract available at www.bmj.com (click "Online first").
LEARN MORE ABOUT Alzheimer's disease at www.alz.org and www.caregiver.org.
Blocking alcohol's euphoria may help control drinking.
THE QUESTION The best treatment for alcohol dependency may be to stop drinking, but not everyone succeeds at that. Might naltrexone (ReVia) -- a drug that blocks the pleasurable "high" of alcohol -- help limit drinking?
THIS STUDY reviewed data from 27 studies involving 3,048 adult alcoholics. Most were randomly assigned to take 50 milligrams of naltrexone or a placebo daily for three months. Treatment generally included counseling or participation in a self-help group. Naltrexone was found to reduce the risk of a return to heavy drinking by 36 percent. People who took the drug also were 18 percent less likely to quit treatment than were those in the placebo groups.
WHO MAY BE AFFECTED BY THESE FINDINGS? People trying to break a dependency on alcohol. The relapse rate for those in treatment is upwards of 50 percent. About 18 million Americans abuse alcohol.
CAVEATS The effects of longer treatment were not determined. About 37 percent of the participants taking naltrexone dropped out of the studies. Common side effects were nausea, dizziness and fatigue.
BOTTOM LINE Alcoholics who are unable to quit drinking completely may want to ask a doctor about naltrexone.
FIND THIS STUDY Issue 1 of the Cochrane Library 2005; abstract available online at www.thecochranelibary.com(search for "CD001867").
LEARN MORE ABOUT alcoholism at www.mayoclinic.comand www.niaaa.nih.gov.
-- Linda Searing