Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia (Cummings JL et al. 2015)

One Journal Club Forward! As my first journal club facilitation, I was admittedly nervous. However once my role shifted from presenter to facilitator of the discussion, I surprised myself in my ability to exchange ideas with experts in Alzheimer’s dementia and related agitation. It was a valuable opportunity for me to explore their opinions regarding the difference between statistical and clinical significance. It was interesting to hear the varying perspectives of the geriatricians with regards to the possible applicability of the treatment to their practice based on risk vs. benefit. On one hand, there was the consideration of geriatric out patients with a high risk of serious side effects of the medication. Given the PD and PK changes that occur with aging and the high morbidity and mortality related to falls, the potential benefit of DMQ might be questionable. Conversely, in a highly agitated institutionalized patient, the potential benefit of an additional option for treatment sounded appealing. This discussion was a good example of the importance of assessing patient specific factors prior to considering a treatment.

This exercise contributed to my residency learning goal 5) I will demonstrate the ability to critically appraise literature in a systematic fashion and determine the applicability of the study to a specific patient.

dextromethorphan-quinidine journal club