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NICE is to restrict drugs for dementia

NICE has stuck by its guns and released a second draft of its appraisal on Alzheimer's disease drugs which continues to heavily restrict their use.

The appraisal committee said donepezil, rivastigmine and galantamine should only be used for the treatment of moderate Alzheimer's, and that memantine should not be used at all.

The decision has predictably prompted a wave of criticism from patients' groups, with the Alzheimer's Society calling the decision 'immoral and unethical.'

Eisai, manufacturer of don-epezil, has insisted it will lodge an appeal.

GPs said the judgment would add to the pressure on them from patients ­ but that NICE had little choice but to judge the drugs on the basis of their evidence base.

Dr George Rae, a member of the GPC prescribing subcommittee and a GP in Whitley Bay, North Tyneside, said: 'There is no doubt there will be pressure [on GPs] from this guidance.

'There is a tremendous amount of support required in families with an Alzheimer's patient and they would be

looking for anything that could relieve that.' But he added: 'If that's the evidence base, far be it for me to suggest otherwise.'

Dr Steve Iliffe, a member of the NICE clinical guideline development group and a GP in Kilburn, north-west London, admitted there was 'a lot of concern' about the guidelines' but maintained it was still only draft.

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