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In reply

We thank Friedman for his comments. He raises several important points, to which we have the following responses.

First, while antipsychotic agents are used for a variety of indications, our article focused exclusively on the development of parkinsonism among older adults with dementia. The use of antipsychotics in this patient population is very common but increasingly questioned because of concerns about efficacy and safety.^1-2 We specifically excluded individuals with evidence of parkinsonism at baseline and therefore cannot comment on the use of antipsychotics beyond the group included in our study.

Risperidone and olanzapine have both been associated with extrapyramidal symptoms when used to manage behavioral and psychological symptoms of dementia (BPSD).³ As reflected in our sample, there is less experience with quetiapine fumarate: this drug accounted for only 2% of atypical antipsychotic use in our study. Only 1 published clinical trial has evaluated quetiapine in the context of . . . [Full Text of this Article]

AUTHOR INFORMATION
Sudeep Gill, MD, MSc; Connie Marras, MD; Geoffrey M. Anderson, MD, PhD; Philip E. Lee, MD; Jerry H. Gurwitz, MD; Paula A. Rochon, MD, MPH

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