Cognitive Effects of Atypical Antipsychotic Medications in Patients With Alzheimer's Disease: Outcomes From CATIE-AD
Lon S. Schneider Dollars for Docs Lilly, maker of ZYPREXA
SCHNEIDER, LON S Calif. Los Angeles Eli Lilly $5,149 2010
Q1-Q3 Advising/Consulting and International Education Programs: $4750, Travel Expenses: $399 LON S. SCHNEIDER, MD, INC.
SCHNEIDER, LON S. Calif. Los Angeles Eli Lilly $7,500 2009
Q1-Q4 Advising/Consulting and International Education Programs: $7500.0 LON S. SCHNEIDER, MD, INC.
Pierre N. Tariot Dollars for Docs Pfizer, Lilly
TARIOT, PIERRE N Ariz. Phoenix Pfizer $6,180 2009
Q3-Q4 Professional Advising: $147.00, Expert-Led Forums: $4000.00, Meals: $721.00, Business Related Travel: $1312.00 TARIOT, PIERRE N
TARIOT, PIERRE N. Ariz. Phoenix Eli Lilly $6,250 2009
Q1-Q4 Advising/Consulting and International Education Programs: $6250.0 TARIOT, PIERRE N.
Cognitive Effects of Atypical Antipsychotic Medications in Patients With Alzheimer's Disease: Outcomes From CATIE-AD Am J Psychiatry Published May 15, 2011
Cheryl L.P. Vigen, Ph.D., Wendy J. Mack, Ph.D., Richard S.E. Keefe, Ph.D., Mary Sano, Ph.D., David L. Sultzer, M.D., T. Scott Stroup, M.D., Karen S. Dagerman, M.S., John K. Hsiao, M.D., Barry D. Lebowitz, Ph.D., Constantine G. Lyketsos, M.D., M.H.S., Pierre N. Tariot, M.D., Ling Zheng, Ph.D., and Lon S. Schneider, M.D.
Objective: The impact of the atypical antipsychotics olanzapine, quetiapine, and risperidone on cognition in patients with Alzheimer's disease is unclear. The authors assessed the effects of time and treatment on neuropsychological functioning during the Clinical Antipsychotic Trials of Intervention Effectiveness–Alzheimer's Disease study (CATIE-AD). Method: CATIE-AD included 421 outpatients with Alzheimer's disease and psychosis or agitated/aggressive behavior who were randomly assigned to receive masked, flexible-dose olanzapine, quetiapine, risperidone, or placebo. Based on their clinicians' judgment, patients could discontinue the originally assigned medication and receive another randomly assigned medication. Patients were followed for 36 weeks, and cognitive assessments were obtained at baseline and at 12, 24, and 36 weeks. Outcomes were compared for 357 patients for whom data were available for at least one cognitive measure at baseline and one follow-up assessment that took place after they had been on their prescribed medication or placebo for at least 2 weeks.
Results:
Overall, patients showed steady, significant declines over time in most cognitive areas, including in scores on the Mini-Mental State Examination (MMSE; –2.4 points over 36 weeks) and the cognitive subscale of the Alzheimer's Disease Assessment Scale (–4.4 points). Cognitive function declined more in patients receiving antipsychotics than in those given placebo on multiple cognitive measures, including the MMSE, the cognitive subscale of the Brief Psychiatric Rating Scale, and a cognitive summary score summarizing change on 18 cognitive tests.
Conclusions:
In CATIE-AD, atypical antipsychotics were associated with worsening cognitive function at a magnitude consistent with 1 year's deterioration compared with placebo. Further cognitive impairment is an additional risk of treatment with atypical antipsychotics that should be considered when treating patients with Alzheimer's disease.
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Clinical trial information: drugs used antipsychotics Zyprexa, Seroquel, Risperdal and antidepressant Celexa
CATIE-Alzheimer's Disease Trial
Sponsor: National Institute of Mental Health (NIMH)
Information provided by: National Institute of Mental Health (NIMH
ClinicalTrials.gov Identifier: NCT00015548
Purpose
The CATIE Alzheimer's Disease Trial is part of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Project. The study is for people with Alzheimer's disease who are having trouble with their thinking or behavior. In particular, this study is trying to find out the best treatment for people who have hallucinations (seeing or hearing things that aren't there), delusions (false beliefs), or agitation. The design of the trial helps to increase the chance that participants in the study receive a medication that helps them. The study uses three medications known as atypical antipsychotics (olanzapine, quetiapine, risperidone), which are the newest medications that are currently available for treating these problems. Participants may also receive an antidepressant (citalopram). The trial lasts for 36 weeks. Participants are given a thorough evaluation at no cost to ensure that this study is appropriate. In addition, the caregiver, family member, or friend who comes with the participant will be offered an educational program about Alzheimer's disease.
The 2 principal investigators, listed above in Dollars for Docs database
Investigators
Principal Investigator: Lon Schneider, MD University of Southern California
Principal Investigator: Pierre Tariot, MD University of Rochester
Health Authority: United States: Federal Government
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The Federal Government should not allow doctors who take income from pharmaceutical companies to be Principal Investigators in drug trials. That's my opinion.
In fact, why does the Government allow doctors to take any personal income from pharmaceutical companies, and why does the United States government allow pharmaceutical companies to pay them?
Until that connection stops we have a corporate ran health system in America, the DoJ fines for illegal marketing are stacking up, kids are being placed on antipsychotics like candy, the health system in America is tainted by manufacturer influence and until that stops, we have no pure scientific studies to consider as truth and unbiased.
There is already a FDA black box warning for antipsychotics and use in patients with Dementia.
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