All drugs can have serious side effects
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《英国医生杂志》
EDITOR—In their review article, Lee et al say that further evidence is required before atypical antipsychotics can be endorsed in the management of behavioural and psychological symptoms of dementia.1 Of the five randomised trials reviewed, only three contained information on adverse events, and only two of these reported on the number of serious adverse events.
Currently, no atypical antipsychotic is licensed for the treatment of behavioural disturbances in dementia. In March 2004, after analysing data from randomised placebo controlled clinical trials and finding approximately three times the risk of cerebrovascular adverse events in patients taking risperidone or olanzapine compared with placebo, the Committee on Safety of Medicines advised that risperidone or olanzapine should not be used for the treatment of behavioural symptoms of dementia.2 Perhaps this is all the evidence needed, but perhaps not. Let us not forget that all drugs can have serious side effects and that non-pharmacological interventions are important.
Anna V Richman, specialist registrar in old age psychiatry
Mossley Hill Hospital, Liverpool L18 8BU emileandanna@tinyworld.co.uk
Competing interests: None declared.
References
Lee PE, Gill SS, Freedman M, Bronskill SE,Hillmer MP, Rochon PA. Atypical antipsychotic drugs in the treatment of behavioural and psychological symptoms of dementia: systematic review. BMJ 2004;329: 75-8
Committee on Safety of Medicines. Atypical antipsychotic drugs and stroke. London: CSM, 2004. (CEM/CMO/2004/1.)
Currently, no atypical antipsychotic is licensed for the treatment of behavioural disturbances in dementia. In March 2004, after analysing data from randomised placebo controlled clinical trials and finding approximately three times the risk of cerebrovascular adverse events in patients taking risperidone or olanzapine compared with placebo, the Committee on Safety of Medicines advised that risperidone or olanzapine should not be used for the treatment of behavioural symptoms of dementia.2 Perhaps this is all the evidence needed, but perhaps not. Let us not forget that all drugs can have serious side effects and that non-pharmacological interventions are important.
Anna V Richman, specialist registrar in old age psychiatry
Mossley Hill Hospital, Liverpool L18 8BU emileandanna@tinyworld.co.uk
Competing interests: None declared.
References
Lee PE, Gill SS, Freedman M, Bronskill SE,Hillmer MP, Rochon PA. Atypical antipsychotic drugs in the treatment of behavioural and psychological symptoms of dementia: systematic review. BMJ 2004;329: 75-8
Committee on Safety of Medicines. Atypical antipsychotic drugs and stroke. London: CSM, 2004. (CEM/CMO/2004/1.)