All drugs can have serious side effects

BMJ 2004; 329 doi: http://dx.doi.org/10.1136/bmj.329.7462.404 (Published 12 August 2004) Cite this as: BMJ 2004;329:404
  1. Anna V Richman (emileandanna{at}tinyworld.co.uk), specialist registrar in old age psychiatry
  1. Mossley Hill Hospital, Liverpool L18 8BU

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    Credit: PHANIE/REX

    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.


    • Competing interests None declared.


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