People with dementia are prone to agitation and even aggression. This can be extremely difficult for families or institutions to manage.
In the past, such patients have been medicated with powerful antipsychotic drugs such as haloperidol (Haldol), quetiapine (Seroquel), aripiprazole (Abilify) and olanzapine (Zyprexa). The drawback of these drugs is that they put older people with dementia at risk of premature death because of heart related events or infections.
That leaves caregivers with a terrible challenge. Calming an agitated and confused Alzheimer’s patient with an antipsychotic drug could hasten his death.
Combining Two Older Drugs:
Now a study has shown that a combination of two medications can ease agitation without serious complications. One of the drugs is dextromethorphan, a primary ingredient in cough medicine sold over the counter. It is the DM in Robitussin DM and similar products.
The other is medication is quinidine, a century-old drug used to treat heart rhythm abnormalities.
Calming Agitation and Aggression:
In this 10 week study, 220 people with Alzheimer’s disease were randomly assigned to receive either the quinidine-dextromethorphan combination or a placebo. The treatment reduced agitation and aggression significantly compared to placebo.
Downsides of the Combo:
An accompanying editorial gives the study high marks, but points out that this drug combination could be dangerous if added to a serotonin reuptake inhibitor such as fluoxetine. There were concerns that patients might experience fatigue, diarrhea, dizziness or falls, but these were not apparent in the study.
If further research confirms that this combination is useful in dealing with the agitation of Alzheimer’s disease, it could help both patients and caregivers deal with a challenging situation.
