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Drug Combination Reduces Agitation in Alzheimer's Patients

  • Carol Pearson

Dementia is a global problem that will only increase as people live longer. The World Health Organization says most of the burden, in terms of care giving, cost of medications, and loss of income due to care-giving, will fall on low to middle income countries. Last March, the WHO held a conference calling for global action on dementia.

Dementia is a collective name for a progressive, degenerative disease that affects memory, thinking, behavior and emotion. It can involve personality and mood changes. And frequently, those with dementia or Alzheimer's, its most common form, get agitated or even aggressive.

Dr. Jeffrey Cummings, director of the Cleveland Clinic Lou Ruvo Center for Brain Health, said agitation is hard to bear both for caregivers and patients.

"Agitation in Alzheimer's disease is one of the most disabling aspects of the disease," Cummings said. "It interferes with the patient's life. It interferes with the ability of the caregiver to take care of the patient. It degrades the quality of life of both the patient and the caregiver."

Cummings led a study involving 220 Alzheimer's patients who also had agitation. Some of the patients got a placebo. Others got a drug cocktail that combined dextromethorphan and quinidine.

Dextromethorphan is commonly used in cough medicine. Quinidine is normally used to regulate an abnormal heart beat. Cummings said the combination pill had a substantial effect, greatly reducing agitation compared to the patients who got the placebo. Furthermore, he said, the caregivers also benefited. "There was a reduction in the stress experienced for caregivers of the patients who were treated with the dextromethorphan-quinidine combination.

While both drugs have been approved by the U.S. Food and Drug Administration, the combination pill is not. More studies need to be done before results can be presented to the agency for approval. The study appears in JAMA, the Journal of the American Medical Association.