Antipsychotic Drugs in Dementia
What Should Be Made of the Risks?
Peter V. Rabins, MD, MPH;
Constantine G. Lyketsos, MD, MHS
JAMA. 2005;294:1963-1965.
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The introduction of the first antipsychotic drug, chlorpromazine, into clinical practice more than 50 years ago revolutionalized psychiatry and neurology.1 The efficacy of this drug and other drugs in the phenothiazine class demonstrated that a disease considered a "mental illness" could respond to a biologically mediated therapy and heralded the introduction of other neuromodulating therapies such as levodopa for Parkinson disease.
However, since their introduction, the phenothiazines and other antipsychotic neuroleptic agents have raised challenging questions about their adverse effects and toxic effects. Skeptics of the effectiveness of antipsychotic drugs in schizophrenia suggested that sedation rather than a direct drug action was causing patients to report fewer symptoms. This question was resolved by one of the first randomized controlled trials (RCTs) with an active placebo (the original streptomycin trial2 for tuberculosis had been randomized but the control group was not . . . [Full Text of this Article]
Author Affiliations: Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Md.
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