The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial

@article{Ballard2009TheDA,
  title={The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial},
  author={Clive G Ballard and Maria Luisa Hanney and Megan Theodoulou and Simon Douglas and Rupert McShane and Katja Kossakowski and Randeep Gill and Edmund Juszczak and Ly-Mee Yu and Robin J. Jacoby},
  journal={The Lancet Neurology},
  year={2009},
  volume={8},
  pages={151-157}
}
Continued use of antipsychotic drugs increased long-term mortality in patients with Alzheimer disease
  • C. Hirsch
  • Psychology, Medicine
    Annals of Internal Medicine
  • 2009
TLDR
In patients with Alzheimer disease, continued use of antipsychotic drugs increased long-term mortality, and the results show a sustained higher mortality rate among patients continuing on APDs.
Comparison of longer-term safety and effectiveness of 4 atypical antipsychotics in patients over age 40: a trial using equipoise-stratified randomization.
TLDR
A lack of effectiveness and a high incidence of side effects with 4 commonly prescribed atypical antipsychotics across diagnostic groups in patients over age 40 are found, with relatively few differences among the drugs.
Second-generation antipsychotics in dementia: beyond safety concerns. A clinical, systematic review of efficacy data from randomised controlled trials
  • S. Gentile
  • Psychology, Medicine
    Psychopharmacology
  • 2010
TLDR
Because of their undemonstrated effectiveness, SGAs should be avoided in patients with dementia complicated by psychotic and/or behavioural symptoms and further researches are urgently needed to identify useful pharmacological strategies that can be used to improve the clinical condition of such patients and to reduce burden to caregivers when behavioural interventions are ineffective.
How Legislation on Decisional Capacity Can Negatively Affect the Feasibility of Clinical Trials in Patients with Dementia
TLDR
The AdCare study, a non-profit, randomized, placebo-controlled, double-blind, multicentre, pragmatic trial coordinated by the Italian National Institute of Health, aimed to evaluate the long-term safety and efficacy profiles of three atypical antipsychotic drugs in treating psychosis, aggression and agitation in outpatients with AD.
How legislation on decisional capacity can negatively affect the feasibility of clinical trials in patients with dementia.
TLDR
The AdCare study showed that an excessively rigid regulation can become a major obstacle while carrying out therapeutic research with incapacitated persons.
Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia.
TLDR
There is low-quality evidence that antipsychotics may be successfully discontinued in older people with dementia and NPS who have been taking antipsychotic drugs for at least three months, and that discontinuation may have little or no important effect on behavioural and psychological symptoms.
Pharmacological treatments for neuropsychiatric symptoms of dementia in long-term care: a systematic review
TLDR
There is limited evidence to support the use of some atypical antipsychotics and other medications for NPS in LTC populations, however, the generally modest efficacy and risks of adverse events highlight the need for the development of safe and effective pharmacological and non-pharmacological interventions for this population.
Choice of observational study design impacts on measurement of antipsychotic risks in the elderly: a systematic review
TLDR
Choice of observational study design is critical in studying the adverse effects of antispychotics and good quality observational studies are required, that employ appropriate study designs that are robust towards unmeasured confounding, to confirm the potential excess risk of hip fracture and pneumonia with antipsychotics.
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