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Evid Based Med doi:10.1136/eb-2013-101225
  • Harm
  • Cohort study

Use of psychotropic medication in Alzheimer's disease is associated with more rapid cognitive and functional decline

  1. Edward C Lauterbach
  1. Departments of Psychiatry and Internal Medicine (Neurology Section), Mercer University School of Medicine, Macon, Georgia, USA
  1. Correspondence to: Dr Edward C Lauterbach
    Departments of Psychiatry and Internal Medicine (Neurology Section), Mercer University School of Medicine, 655 First Street, Macon, GA 31201, USA; eclbgnp{at}earthlink.net

Commentary on Rosenberg PB, Mielke MM, Han D, et al. The association of psychotropic medication use with the cognitive, functional and neuropsychiatric trajectory of Alzheimer's disease. Int J Geriatr Psychiatry 2012; 27:1248–57.

Context

Psychotropic medicines are commonly prescribed in Alzheimer's disease (AD), yet their long-term effects are unknown. Rosenberg and colleagues determined AD clinical outcome trajectories after psychotropic exposure in the Cache County Dementia Progression Study. The authors hypothesised a more rapid clinical decline with antipsychotics and benzodiazepines and an improved status with antidepressants.

Methods

The authors studied 230 participants diagnosed with AD using the Diagnostic and Statistical Manual of Mental Disorders 1987 (DSM-III-R) and the NINCDS-ADRDA Alzheimer's Criteria. Participants were followed up for an average of 3.7±2.49 years (median follow-up of one visit). Mean changes in adjusted Mini-Mental State Examination (MMSE), Clinical Dementia Rating sum of six domains (CDR-Sum) and 10-item Neuropsychiatric Inventory—Clinician Rating total score (NPI-Total) ratings since AD diagnosis …

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