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Medical Forum / Diseases and Disorders / Alzheimer's / April 2004FYI:More warnings on Zyprexa and Risperdal
Found this on another list. Just more info for those with LO's taking the drugs. http://newsvote.bbc.co.uk/mpapps/pagetools/print/news.bbc.co.uk/1/hi/health/3546 215.stm This information may be useful to your doctor. http://www.emea.eu.int/pdfs/human/press/pus/085604en.pdf In March 2004 the EMEA issued a Public Statement on Cerebrovascular adverse events and increased mortality in elderly patients with dementia, based on data from clinical trials that show increased risk of cerebrovascular adverse events and mortality in elderly patients with dementia receiving olazapine. This public Statement can be found on the EMEA Website (http://www.emea.eu.int/htms/human/drugalert/drugalert.htm). It is to be noted that olanzapine is not approved for the treatment of dementia-related psychosis and/or behavioural disturbances and is not recommended for use in this particular group of patients.  SignatureMare mfcoleman@THEOLEmindspring.com http://www.muggsmulcher.com/kstuff/a.s.a/intro.htm alt.support.alzheimers' FAQs and Stuff Pages Here's another article on the newer (atypical) antipsychotics (e.g., Zyprexa). Olanzapine Labeling Change Indicates Risk of Hyperglycemia, Diabetes Medscape Staff Report March 22, 2004 Eli Lilly and Co. has notified healthcare professionals of a revision to the labeling for olanzapine (Zyprexa), describing the increased risk of hyperglycemia and diabetes in patients taking the drug. The U.S. Food and Drug Administration (FDA) has asked all manufacturers of atypical antipsychotic medications, including Lilly, to add this warning statement to drug labeling, according to an alert sent today from MedWatch, the FDA's safety information and adverse event reporting program. In addition to olanzapine, the atypical antipsychotic class includes clozapine (Clozaril; Novartis), risperidone (Risperdal; Janssen), quetiapine (Seroquel; AstraZeneca), ziprasidone (Geodon; Pfizer), and aripiprazole (Abilify; Bristol Myers Squibb and Otsuka American Pharmaceutical). According to the revised olanzapine labeling, "Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients treated with atypical antipsychotics." The revised labeling recommends that "[p]atients with an established diagnosis of diabetes mellitus who are started on atypical antipsychotics should be monitored regularly for worsening of glucose control. Patients with risk factors for diabetes mellitus (e.g., obesity, family history of diabetes) who are starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatment." In addition, all patients treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia, including polydipsia, polyuria, polyphagia, and weakness, the labeling states. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the suspect drug. http://www.medscape.com/viewarticle/472363 I am delighted to say that the antipsychotics are now, at least for the moment, out of the discussion for my mother but as late as last week we were considering them. The hospice nurse came back with this message from the hospice doctor after I had said that I would consider the Risperdal at the lowest possible dosage if in another week we did not have some relief from the night panics caused by the delusions and hallucinations my mother was experiencing at the time........ "I never consider Risperdal without first trying haladol" Now I have seen some victims of haladol and thought that it was the worst possible choice of antipsycotics. What is the thought here? Obviously, I need to do some more research before it again becomes a topic of conversation with mother's doctor. Beverly > Here's another article on the newer (atypical) antipsychotics (e.g., > Zyprexa). [quoted text clipped - 43 lines] > > http://www.medscape.com/viewarticle/472363 >I am delighted to say that the antipsychotics are now, at least for the >moment, out of the discussion for my mother but as late as last week we were [quoted text clipped - 9 lines] >need to do some more research before it again becomes a topic of >conversation with mother's doctor. Beverly, A rule of thumb is to start low and go slow no matter which drug is decided upon. Take note of changes that occur and discuss other treatment options if they become overwhelming. Extrapyramidal symptoms and tardive dyskinesia (adverse motor effects) are recognized side-effects of the traditional drugs (e.g., Haldol = haloperidol, an established typical neuroleptic). These side-effects are reduced or non-existent in the new, atypical neuroleptics. But now there are a series of negative side-effects associated with the the latter class (e.g., stroke, hyperglycemia, diabetes). Nothing is easy. Trust the doctors decision and if you notice a change for better or worse in your Mom, don't hesistate to voice your concern. Take care, Darryl. Grayson has been gone for three years, but when I was attending a local NG in Florida, no one liked haldol. That was the last drug any of them would think of using. I've never had any experience with it. Gwen Signature================================= Ability is what you're capable of doing. Motivation determines what you do. Attitude determines how well you do it. - Lou Holtz ================================= | >I am delighted to say that the antipsychotics are now, at least for the | >moment, out of the discussion for my mother but as late as last week we were [quoted text clipped - 29 lines] | Take care, | Darryl. Your doctors should address pro and cons, risk factors of all medications they are considering. I have seen Haldol used with very aggressive patients quite successfully, and by successfully I mean allowing them to maintain their dignity and quality of life. Each drug has its risks and benefits, and works uniquely on each person. LA > Grayson has been gone for three years, but when I was attending a local NG > in Florida, no one liked haldol. That was the last drug any of them would [quoted text clipped - 8 lines] > - Lou Holtz > ================================= |
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