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MeReC Extra 39

The National Prescribing Centre has published MeReC Extra 39 (PDF) which covers the results of the DART-AD study and the update to the schizophrenia guidelines from the National Institute for Health and Clinical Excellence (NICE).

This MeReC discusses the DART-AD study which found that patients with Alzheimer’s disease who continued on treatment with antipsychotic medication with the aim of controlling behavioural or psychiatric problems had a higher risk of death than those who were switched to placebo.

DART-AD was a 12 month study in 165 patients with Alzheimer’s disease. 77% of those patients who received placebo were still alive at the end of the study compared to 70% of those who received active treatment with an antipsychotic.

The NPC recommend that clinicians implement NICE recommendations (QRG) that antipsychotic drugs are only used in cases of severe distress or where there is a immediate risk of harm to the patient or others.

This MeReC also discusses the recently updated NICE guidance for schizophrenia (QRG). Previously the guidance recommended using second generation (atypical) antipsychotics but recent reviews have indicated that treatment choice should be based on individual needs as opposed to the potential for side effects.

Action: Clinicians who see patients with Alzheimer’s disease or schizophrenia will find this information useful and informative.