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Short Term Solution

Dear Reader,

Millions of Alzheimer's patients in assisted living facilities have been given antipsychotic drugs, with little or no evidence to support such use, according to Dr. P. Murali Doraiswamy of Duke University.

Dr. Doraiswamy, a dementia specialist, made this statement during a HealthDay News interview discussing a new study about the effects of antipsychotic drugs on Alzheimer's patients. And sadly, we can read between the lines: Powerful drugs are often forced on unruly AD patients to calm them quickly.

If you or someone you care about has Alzheimer's disease (AD) – whether they're being cared for at home or in a special facility – please keep reading for an important caution.

Lives in the balance

"It's an eye-opening study since it was one of the few non-company sponsored studies to look at long-term risks," Dr. Doraiswamy told HealthDay.

That's the kind of recommendation we like to see.

To test the effect antipsychotic drugs might have on mortality risk, researchers at the Wolfson Centre for Age-Related Diseases at King's College London recruited 165 AD patients who lived in assisted care facilities. Each of these patients was regularly taking at least one of five antipsychotic drugs.

Subjects were randomly divided into two groups: Half continued taking their drugs, and half switched to a placebo.

In a recent issue of The Lancet Neurology, the Wolfson team notes a reduction in survival time in the subjects who continued to receive antipsychotics for one year, compared to placebo.

Surviving subjects were followed for an addition two years. The authors write that there was "a significantly increased risk of mortality for patients who were allocated to continue antipsychotic treatment compared with those allocated to placebo."

Fragrant balm

As Dr. Doraiswamy told HealthDay News, there's a place for antipsychotic drugs as a measure of last resort in patients who exhibit dangerous behavior. "But only for the shortest possible time at the lowest possible dose."

The Wolfson team makes the same point, adding that the increase in mortality emphasizes "the need to seek less harmful alternatives for the long-term treatment of neuropsychiatric symptoms in these patients."

Less harmful alternatives? Well, botanical extracts might not have much affect on an aggressively dangerous AD patient, but they might work wonders for mild-to-moderately agitated patients.

Researchers at the Medical Plant Research Centre (MPRC) in the UK have studied a wide variety of botanicals in the treatment of Alzheimer's. In 2004, MPRC professor Elaine Perry presented data that showed sage to have a significant effect on behavior and attention. And when lemon balm was added to sage, the combination improved memory and mood.

Professor Perry told Reuters Health: "Lemon balm reduced agitation and improved quality of life in people with Alzheimer's disease."

Talk to your doctor before using botanical extracts. And for best results, consult an experienced herbalist.

...and another thing

"Aggressive Drug Marketing May Endanger People"

When I saw that Reuters Health headline recently, my sarcasm meter lit up like a Christmas tree…

No! Really? Do tell!

The Reuters article features an interview with Dr. David Kao who published an analysis of drug marketing in the British Medical Journal late last year. Dr. Kao "reveals" what many e-Alert readers already know: Drug companies actually pay special fees to put drug approval applications on a fast track. He doesn't address the obvious conflict of interest in having major drug companies underwrite the cost of the approval process. But he does highlight the safety problem.

According to Dr. Kao, a typical drug review between 1979 and 1986 took more than 33 months. More recently, a review takes about 16 months. The good doctor told Reuters Health: "It's probably not helping drug safety."

Right. And gasoline probably doesn't help put out a fire.

This is how it's been over the past decade or longer – the review process gets short shrift, and the next safety net (if you can call it that) is post-approval surveillance. In other words, the first few thousand consumers who use a new drug are guinea pigs in a safety trial. And when a drug is truly bad – such as Vioxx – many people die in the process.

Dr. Kao rightly points out: "We just have very poor post-approval surveillance now." But then he completely goes off the rails with this bon mot: "People are going to want new drugs and it is going to be impossible to guarantee their safety before a lot of people get them."

People are going to want new drugs? No. Drug company executives want new drugs to expand their markets. People just want drugs that work and are safe. Period. And that's clearly going to be a hit-or-miss proposition as long as drug company money is deeply entwined in the approval process.

To Your Good Health,

Jenny Thompson

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