Dextromethorphan-Quinidine: not quite ready for prime time

We only chose one article for this month’s #GeriMedJC.  It was a randomized controlled trial of dextromethorphan-quinidine for agitation in Alzheimer disease:

Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia: A Randomized Clinical Trial. JAMA. 2015 Sep 22-29;314(12):1242-54. 


There was pretty much consensus that dextromethorphan-quinidine is not quite ready for prime time in the management of agitation in Alzheimer disease.  Among some important concerns raised were:

  • trial was funded by pharma
  • last-observation carried forward is not a recommended method for imputing missing data in dementia trials
  • biases introduced by the choice of rescue medication, Lorazepam
  • agitation in this trial lumped together verbal aggression, physical aggression, and non-aggressive activity (pacing, restlessness)
  • mode of action

Thank you to all those who joined in the discussion:

If you missed out on the tweetchat, don’t despair!  Download the transcript here.

See you on December 18, 2015 at 08:00 ET for the next #GeriMedJC!  Articles will be announced in advance by @GeriMedJC

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