Do neuroleptic drugs hasten cognitive decline in dementia?

BMJ 1997;314:1411 (10 May)

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Do neuroleptic drugs hasten cognitive decline in dementia?

Carriers of apolipoprotein E 4 allele seem particularly susceptibleto their effects

Editor–We agree with Rupert McShane and colleagues thatthere is evidence for an association between treatment withneuroleptic drugs and a more rapid cognitive decline in dementia,but we would also point out an additional association with theapolipoprotein {isin} 4 allele.¹ We followed up 135 subjects from theCamberwell dementia case register.² The patients all fulfilledthe criteria of the National Institute of Neurological and CommunicativeDisorders and Stroke and the Alzheimer's Disease and RelatedDisorders Association criteria for Alzheimer's disease and hadan initial score on the mini mental state examination of 5 points(to avoid floor effects) over one year. Throughout this period23 took neuroleptics and 112 had no evidence of use of neuroleptics.Neither age; sex; initial score on the minimental state examination;nor previous evidence of hallucinations, persecutory ideation,aggression, or sleep disturbance . . . [Full text of this article]

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Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow up: Rupert McShane, Janet Keene, Kathy Gedling, Christopher Fairburn, Robin Jacoby, and Tony Hope
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