For dementia, common painkillers may work best: study

19.07.2011 [19:12]
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Baku, July 19 (AZERTAC). Ordinary painkillers such as paracetamol may work better than the risky antipyschotic drugs often prescribed to calm agitation in people with dementia, according to a study released Monday.

Patients with severe dementia showed significantly less agitation when taking ordinary pain medicines than a control group given standard treatment, showed the study, published online by the British Medical Journal.

Extreme aggression and agitation are common symptoms of advanced dementia, including Alzheimer`s disease.

The condition is usually compounded by pain, and the frequent inability of the persons afflicted to clearly express the nature of their discomfort.

Powerful antipsychotics and antidepressants are often the drugs of first choice and, in many countries, are prescribed for agitation to around half of dementia patients in nursing homes.

Remarkably, little research has explored the effectiveness of off-the-shelf pain pills and other proven pain-relief drugs in quelling these common and debilitating symptoms.

To find out just how well they might work, a team of scientists led by Dag Aarsland, a professor at the Karolinska Institute in Stockholm, treated 352 patients from 16 Norwegian nursing homes -- all with severe dementia, most in their mid-to-late 80s -- with one of four pain-relief medications.

Over a period of eight weeks, 70 percent took a large daily dose of paracetamol and 20 percent were given buprenorphine, a semi-synthetic opioid used to treat addiction and moderate-to-acute pain.

The other 10 percent took stronger painkillers, morphine or pregabalin, an anti-convulsant.

A control group continued their usual treatment, including certain antipsychotics or anti-depressants.

Experts who did not know which patients had taken which drugs did interviews during the trial and a four-week follow up.

"The intervention produced a clinically and statistically significant reduction in agitation and pain," note Paul Rosenberg and Constantine Lyketsos, professors at John Hopkins University, in a commentary also published in the British Medical Journal.

Thirty-five million people worldwide have dementia, a number expected to more than triple by 2050 as populations across the planet age.

For dementia, common painkillers may work best: study

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