Home » News » Side Effects Limit Alzheimer’s Meds

Side Effects Limit Alzheimer’s Meds

Antipsychotic drugs are frequently prescribed to Alzheimer’s patients to help manage symptoms of delusions, agitation or aggression. A new study finds that the long-term effectiveness of three commonly used medications did not exceed that of a placebo because of the significant side effects accompanying the medications.

The nationwide study was led by Lon Schneider, professor of psychiatry, neurology and gerontology at the Keck School of Medicine of the University of Southern California (USC).

The Phase I results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Alzheimer’s Disease Study, funded by the National Institutes of Mental Health, appear in this week’s New England Journal of Medicine. The study is highly anticipated, because it provides the first long-term comparative look at the three major antipsychotic drugs now used “off label” to treat difficult symptoms of Alzheimer’s disease.

“We thought overall the drugs would show their effectiveness,” explains Schneider. “The answer is yes, they are somewhat effective, but overall the efficacy is offset by adverse events that resulted in discontinuing the medication. It was a surprise, in that the expert opinion which drove this study was that these drugs are particularly useful in treating these difficult symptoms.”

Almost 3⁄4 of all Alzheimer’s patients suffer delusions or aggression, says Schneider, which makes their care particularly difficult. The study’s 421 participants at 42 sites nationwide all had Alzheimer’s disease and were experiencing delusions, hallucinations, aggression or agitation that disrupted their daily functioning.

“The findings here look at the time to discontinuation for the antipsychotics versus the placebo, and that time difference reflects the overall effectiveness of the medication. By that measure, the medications were not better than placebo,” he explains. “Patients on the medications were more likely to discontinue because of the side effects, offsetting the efficacy.”

Side effects from the three antipsychotic medications – olanzapine, quetiapine, and risperidone – ranged from sedation, weight gain and confusion to worsening psychosis.

Almost a quarter of those taking olanzapine quit because of adverse events, as did 18% on risperidone and 16% on quetiapine. Those on all three medications were significantly more likely to discontinue treatment than those who received a placebo.

Ultimately between 77 to 85% of study participants discontinued their medication, either because of adverse side effects or no improvement.

“The results suggest antipsychotic drugs should be prescribed only with some deliberation,” says Schneider.

This research represents only Phase I of the $16.9 million CATIE Alzheimer’s disease study, says Schneider. In CATIE– designed to resemble real-world prescribing patterns– patients in the study were allowed to switch double-blindly to a second antipsychotic medication or the antidepressant citalopram if they discontinued the first.

Future results will show which treatments, if any, are cost effective and will help improve symptoms, quality of life, and functioning, as well as caregiver burden, thereby delaying nursing home placement.

Source: USC

Side Effects Limit Alzheimer’s Meds

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Side Effects Limit Alzheimer’s Meds. Psych Central. Retrieved on March 26, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.