Alzheimer's Drug Won't Ease Patients' Agitation

But Aricept may help stave off cognitive decline, researchers say.

By Amanda Gardner
HealthDay Reporter
Wednesday, October 3, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

WEDNESDAY, Oct. 3 (HealthDay News) -- Aricept, a drug commonly used to treat the cognitive symptoms of Alzheimer's disease, is no better than a placebo when it comes to treating the agitation associated with the illness, a new study finds.

When combined with other research, the trial suggests that doctors and patients shouldn't rule out using the medication, but they shouldn't count on it either, experts said.

"This is part of a greater dialogue about how you deal with these behavioral symptoms of Alzheimer's and I think the findings are relatively consistent with what's been seen before," said William Thies, vice president of medical and scientific relations at the Alzheimer's Association.

Previous trials have shown some variation in the effectiveness of cholinesterase inhibitors -- the class of medicines to which Aricept (donepezil) belongs -- in easing agitation. However, any positive effect from the drug has typically been small.

Although memory loss and cognitive dysfunction are hallmarks of Alzheimer's disease, behavioral disturbances such as agitation can cloud other changes, experts say. The group of symptoms known as "agitation" can lead patients to pace, wander, shout and become aggressive.

"These kinds of symptoms are very difficult to deal with and, both from a care and a medical perspective, they are the most likely causes of people moving into some sort of care facility as opposed to being cared for at home," Thies noted. "Memory issues often can be dealt with but when people get aggressive and agitated, that is frequently going to go beyond what a single caregiver can manage."

"Agitation is difficult to address in the first place," added Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City.

Antipsychotics and tranquilizers are commonly used to treat these behavioral disturbances but the effect -- if any -- is usually small and the side effects can be severe.

Cholinesterase inhibitors like Aricept have been shown to improve cognitive outcomes but the benefits in terms of behavioral disturbances have been unclear.