Which Drugs (or None) for Alzheimer Disease?

Because antipsychotics often are employed to treat agitation that accompanies dementia, British investigators conducted this randomized, placebo-controlled trial to evaluate the effects of quetiapine (Seroquel, an atypical antipsychotic) and rivastigmine (Exelon, a cholinesterase inhibitor). They recruited 93 patients, most with severe dementia, from a variety of nursing facilities and assigned them to one of three treatment groups: quetiapine plus placebo, rivastigmine plus placebo, or double placebo.

Patients were evaluated at 6, 12, and 26 weeks. The primary outcome variable was the effect of treatment on agitation, but cognitive function also was assessed. Of the 93 subjects, 71 (22 rivastigmine, 23 quetiapine, 26 placebo) completed the …