Alzheimer's Society comment on trial results of antipsychotic drug brexpiprazole for use in dementia agitation

Dr Richard Oakley, Associate Director of Research at Alzheimer’s Society, said:

'Over 90% of people with dementia experience behavioural changes like agitation, which can be extremely distressing for them as well as their carers.'

'This study looked at whether an antipsychotic drug called brexpiprazole, which is already licenced for schizophrenia, could be effective for treating agitation in people with Alzheimer’s disease. Results shared today were very encouraging, showing a positive impact on agitation but do need caution, given the side effects and historical over-use of this type of drug. '

'The research promisingly also suggested brexpiprazole may be safer than previous generations of antipsychotics, with low risk of sedation, loss of memory and thinking skills, and falls.'

'However, inappropriate use of other antipsychotic drugs, for example at high doses or over long periods of time, can lead to harmful side effects and potentially even death, so it’s important to note brexpiprazole, if approved, would have to be prescribed carefully, and considered a short-term option only.'

'This trial ran for a relatively short time, so we would also need further investigation into its longer-term safety including risk of mortality, impact, and to understand its effectiveness and safety amongst older, frailer people living with other health conditions.'

Antipsychotic medication used to be the go-to treatment option for agitation symptoms but Alzheimer’s Society campaigning led to a reduction in their inappropriate use and saved tens of thousands of lives.

'Our funded research led by Professor Clive Ballard, showed that person-centred care could help to manage agitation and aggression effectively whilst also reducing inappropriate prescribing of antipsychotics by 40%.'

'We know that research will beat dementia, so it’s essential the Government delivers on its promise to double dementia research funding through the National Dementia Mission.'
 
Professor Clive Ballard, Deputy Pro-Vice-Chancellor and Dean of the University of Exeter Medical School, said:

'While the ultimate aim is to find a cure, it’s crucial we keep up momentum in research focusing on managing substantial Alzheimer’s disease symptoms such as agitation, as we know how distressing they can be.'

'The results today look promising and brexpiprazole appears to be modestly more effective than previous generations of these drugs and, critically, with a better safety profile. However, we do need some caution as there is more to learn about the longer-term effects of these drugs, risk of mortality and how they might impact an older, frailer population.'

'As my team’s research has shown, person-centred care – focusing on things like improving appetite or sleep – is an effective alternative to antipsychotics.'

Our work with Alzheimer’s Society culminated in new guidelines being published around using antipsychotics, reducing inappropriate use and saving thousands of lives.