Reply #2: Yes, but it works.

[eallen]

Consider an elderly patient in the middle stages of Alzheimer's, who without Zyprexa presents the paranoia that brings, and the agitation and constant worry and erratic behavior subsequent to that. If Zyprexa relieves that, and hence means the difference between the patient continuing to live at home, which is much the patient's preference, or having to live in a nursing home, are the risks worth the benefit? Don't be too quick to answer, until you have dealt with this, until you have been called by the police time and again because of a demented family member's behavior, until you have tended to their medical needs, until you have made the decision they need nursing care, and then watched that final decline. When someone is suffering an incurable and terminal disease, and that end is not too far off, quality of life issues loom quite large. Another few months -- maybe a year? -- living in one's own home, versus a few months less at the other and miserable end? I'd make that trade any day, for myself, and I hope those in whom I entrust that decision, if ever someone needs to make it for me, will do the same.

That doesn't mean in all cases the risks are worth it. Not all dementia brings as certain a decline as Alzheimer's. In a middle-aged patient suffering a mental disease that is not deteriorating and terminal, who might have many years yet to live, the risks are sharper because there is more to lose. And drug companies never should conceal the potential risks from a drug.

But just because a drug has serious risks doesn't mean it's not worthwhile, when they help against even more serious diseases.