For many families caring for an Alzheimer's patient, it is not the memory impairment per se that drives them to place their loved one in a nursing home, so much as the agitation, aggression and even violence that demented patients frequently exhibit. Sedatives and anti-psychotic drugs like haloperidol and thioridazine have been used to treat these symptoms, with only limited success. Some physicians have also prescribed carbamezepine (Tegretol), a drug used to treat epilepsy and other seizure disorders. Now, several rigorous studies have shown that carbamezepine is indeed effective in about three-quarters of patients who take it, and may be as good or better than other medications. Psychiatrists Pierre Tariot and Anton Porsteinsson of the University of Rochester, who spearheaded the study, report that a second study, with 51 patients, was halted prematurely because the drug appeared to be so effective that physicians concluded that further enrollment was not necessary and that all patients should have access to it. Patients on the medicine were less aggressive and agitated, and were more engaged in social activities and required less time to manage. A second anti-seizure medication, divalproex sodium, also appears promising in a small, placebo-controlled pilot study, and a large multicenter trial of that drug has just begun, funded by Abbott Laboratories, which markets divalproex sodium under the brand name Depakote. The results of the Rochester studies were presented publicly at the 6th International Conference on Alzheimer's Disease and Related Disorders in Amsterdam.—June Kinoshita


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