>> Peggy: THERE ARE NO FDA APPROVED DRUGS FOR TREATING
DEMENTIA IN OLDER PEOPLE.
DOCTORS USUALLY USE DRUGS TO TREAT THOSE WITH SCHIZOPHRENIA
OR BIPOLAR DISORDER.
WE FOUND THESE DRUGS WERE NOT EFFECTIVE AND THEY COME WITH
SERIOUS SIDE EFFECTS, DR.
DILIP JESTE.
THANK YOU FOR BEING WITH US.
>> THANK YOU.
>> Peggy: TELL US ABOUT THE FINDINGS WITH DEMENTIA IN OLDER
ADULTS.
>> COMMONLY THERE ARE PSYCHOTIC SYMPTOMS, DID I PRESSES,
AGITATION, SEVERE DEPRESSION.
THOSE ARE COMMON SYMPTOMS.
>> Peggy: DOCTORS PRESCRIBE THE DRUGS.
YOU LOOK AT THEM FOR EFFECTIVENESS AND SIDE EFFECTS
THEIR BRAND NAMES ARE ABILIPHY AND OTHERS.
WHAT DID YOUR RESULTS FIND WITH THESE FOUR DRUGS.
WHY THEY EFFECTIVE.
>> UNFORTUNATELY NOT.
WE FOUND THESE DRUGS WERE NOT EFFECTIVE AND THEY HAD MULTIPLE
SIDE EFFECTS AS A GROUP.
IN INDIVIDUAL PATIENTS SOME MAY WORK.
OVER ALL THERE WAS LACK OF EFFECTIVENESS.
>> Peggy: BEFORE WE GET TO THE SIDE EFFECTS DO THESE DRUGS DO
BETTER IN ALLEVIATING SYMPTOMS OR ACROSS THE BOARD WERE THEY IN
EFFECTIVE.
>> WE DIDN'T FIND SIGNIFICANT DIFFERENCES WITH THE DRUG.
WE HOPED WE WOULD FIND THAT ONE DRUG WORKED BETTER IN SOME
PATIENTS BUT WE CAN'T SEE THAT.
>> Peggy: NEARLY A QUARTER OF THE PATIENTS IN YOUR STUDY
DEVELOPED SERIOUS SIDE EFFECTS.
WHAT ARE WE TALKING ABOUT.
>> THE FOOD AND DRUG ADMINISTRATION DEFINES SERIOUS
AS DEATH, HOSPITALIZATION, EMERGENCY ROOM VISIT FOR A LIFE
THREATENING CONDITION.
SO, THOSE WERE THE SERIOUS SIDE EFFECTS WE SAW IN ABOUT A
QUARTER OF THE PATIENTS.
>> Peggy: WERE THEY CAUSED FROM HEART ATTACKS, STROKES.
WHAT WERE THESE CAUSED FROM, THE TRIP TO THE HOSPITAL.
>> COMMON SERIOUS SIDE AFFECTION FOR PNEUMONIA.
A FEW OF THE PEOPLE HAD TIAs.
>> Peggy: TRANSCHEMIC ATTACKS OR MINI STROKES.
>> THAT'S CORRECT.
SOME HAD AGITATION AND BECAME MORE PSYCHOTIC.
THOSE ARE THE SIDE EFFECTS WHERE THEY NEEDED HOSPITALIZATION.
>> Peggy: LET'S TALK ABOUT THE NON SERIOUS SIDE EFFECTS.
YOUR STUDY FOUND HALF OF THE PATIENTS HAD NON SERIOUS SIDE
EFFECTS.
WHAT WERE THOSE?
>> GENTLE SIDE EFFECTS.
VOMITING, HEADACHE, PAIN IN THE FRONT PART OF THE BODY, NOTHING
SINGLE OR CONSISTENT FOR THE NON SERIOUS SYMPTOMS.
>> Peggy: ARE ANY OF THE PHARMACEUTICAL COMPANIES, SINCE
THESE DRUGS ARE OFF MARKET.
THEY'RE BEING PRESCRIBED WITH NOTHING ELSE OUT THERE.
IS ANYONE WORKING ON A SPECIFIC DRUG FOR THESE DEMENTIA
PATIENTS?
>> THERE IS A LOT OF RESEARCH GOING ON.
COGNITIVE ENHANCERS.
>> Peggy: HELPING THE BRAIN ABILITY.
>> THAT'S CORRECT.
TO IMPROVE COGNITION OF THE PATIENTS LIKE MEMORY PROBLEMS.
WE HOPE THEY AFFECT BEHAVIOR BUT WE DON'T KNOW YET.
>> Peggy: IS THERE ANY BENEFITS TO TAKING THE DRUGS FOR DEMENTIA
PATIENTS THAT DO OUT WEIGHT THE RISKS.
SHORT-TERM USE PERHAPS.
>> PATIENTS HAVE SEVERE PSYCHOTIC SYMPTOMS.
WHERE THE SYMPTOMS CAN BE DANGEROUS TO THE PATIENT
THEMSELVES.
IN SUCH CASES THE DRUGS NEED TO BE USED.
THERE ARE TO OTHER DRUGS FDA APPROVED.
USE OF THOSE DRUGS IN PATIENTS IS APPROPRIATE.
>> Peggy: SHORT-TERM, LESS THAN TWO YEARS OR SO?
>> I WOULD SAY LESS THAN A FEW MONTHS.
>> Peggy: VERY SHORT-TERM TO PREVENT A PSYCHOTIC EPISODE
WHERE PEOPLE ARE ACTING OUT ISSUES TO HURT THEMSELVES.
>> YES, A FEW DAYS OR FEW WEEKS.
>> Peggy: IN LIGHT OF THIS NEW INFORMATION WHAT SHOULD SOMEONE
DO IF THEY'RE TAKING THESE PSYCHOTIC DRUGS AND THEY'RE A
DEMENTIA PATIENT?
>> THEY SHOULD TALK TO THEIR DOCTOR.
FIND OUT IF THE DOCTOR THINKS THE DRUGS ARE WORKING AND ARE
USEFUL FOR THE PATIENT.
THE DOCTOR WILL HAVE EXPERIENCE AND KNOWLEDGE ABOUT COMPARING
AND LOOKING AT THESE DRUGS FOR INDIVIDUAL PATIENTS.
IT'S IMPORTANT TO TALK TO THE DOCTOR BEFORE MAKING CHANGES.
>> Peggy: WE WILL LOOK AT THESE MEDICATIONS ONE MORE TIME.
THESE ARE THE FOUR MEDICATIONS YOU STUDIED.
THE MAIN THICK IS A PATIENT SHOULDN'T JUST STOP TAKING THESE
DRUGS.
>> CERTAINLY STOPPING THE MEDICATION IF SOMEONE HAS BEEN
TAKING IT FOR SOME TIME CAN HAVE ADVERSE EFFECTS.
>> Peggy: INTERESTING WORK DR., DILIP JESTE.
THANK YOU FOR TALKING WITH US.
>> THANK YOU, VERY MUCH FOR HAVING ME.