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Drug effects on Alzheimer’s patients the focus of new study

04/15/09
Antipsychotic drugs are linked to weight and cholesterol changes in those with Alzheimer's Disease.
By Meghan Lewit
Lon S. Schneider, professor of psychiatry, neurology, and gerontology, is principal investigator of the study.

Metabolic side effects of second-generation antipsychotic drugs that commonly occur in patients with schizophrenia are also seen in patients with Alzheimer’s disease who are prescribed the medications for treatment of psychosis or agitation, according to a study led by researchers at the University of Southern California (USC).

These findings from more than 400 elderly patients who participated in the Clinical Antipsychotic Trials of Intervention Effectiveness—Alzheimer’s Disease (CATIE-AD) will be reported April 15 at AJP in Advance, the online advance edition of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association.

The antipsychotic drugs include olanzapine and quetiapine, which were associated with significant weight gain. Additionally, patients taking olanzapine had increases in waist circumference and decreases in high-density lipoprotein (“good”) cholesterol. The likelihood of significant weight gain increased the longer the patients received antipsychotic treatment. Surprisingly, the weight gain reported occurred in women but not men. Risperidone was not associated with adverse metabolic changes.

“These findings are especially troubling because antipsychotics are associated with a higher risk of death and cerebrovascular adverse events in patients with dementia,” stated Lon S. Schneider, M.D., professor of psychiatry, neurology, and gerontology at the Keck School of Medicine of USC and principal investigator of the CATIE-AD study. “They’re often used to minimize disruptive symptoms, but patients should be monitored closely.”

The AJP study, “Metabolic Changes Associated With Second-Generation Antipsychotic Use in Alzheimer’s Disease Patients,” is the second CATIE-AD study to be published in the Journal. The first examined phase 1 outcomes for atypical antipsychotic treatment of psychiatric and behavioral symptoms.

The CATIE-AD study is funded by the National Institute of Mental Health. Other funding received by the individual authors is disclosed in the article itself.