Neither quetiapine nor rivastigmine is effective for dementia-related agitation, but quetiapine is linked with significantly greater cognitive decline than placebo, according to an article published online February 18th by the British Medical Journal.

According to background information, antipsychotic drugs are used in up to 45 percent of nursing homes to treat agitation related to dementia.

In the current study, 93 English patients with Alzheimer’s disease or other dementia and troubled by clinically significant agitation were randomized into three groups: quetiapine, rivastigmine, and placebo.

At 6 and 26 weeks, neither drug improved agitation compared with placebo. However, the British researchers found that patients in the quetiapine group had significantly greater cognitive decline over the course of the study compared with the placebo group, with a two-fold difference in cognitive loss.

The authors noted that the cognitive loss associated with quetiapine is particularly significant because it has been regarded as one of the safer antipsychotic drugs available. Thus, they argue, the role of antipsychotic agents in this patient population becomes increasingly problematic.