The misuse of anti-psychotic drugs to treat Alzheimer's patients is an important issue and I wrote about it some time ago. The issue is important because these medications are missused by physicians and in nursing homes. The Food and Drug Administration warned doctors in 2005 that some anti-psychotic drugs could increase the risk of death when given to older patients in nursing homes. In spite of this, the drugs are still being widely prescribed. An estimated 30% to 60% of nursing home patients in the USA are given the drugs, and many of these patients have Alzheimer's. This practice is done to sedate older people and keep them under control. The rationale is that the patients are "difficult". This is horrifying.Subscribe to The Alzheimer's Reading Room
This newly released study, being published in the journal Lancet Neurology, found that after two years, 46 percent of Alzheimer's patients taking anti-psychotics were alive, versus 71 percent of those not on the drugs.
"Would I want to take a drug that slightly reduced my aggression but doubled my risk of dying? I'm not sure I would," said Clive Ballard, the lead author of this new study
The FDA approved the anti-psychotic drugs for the treatment of schizophrenia, not Alzheimer's, says P. Murali Doraiswamy, chief of biological psychiatry at Duke University Medical Center. The medications do help certain people. If there's no other way to stop an Alzheimer's patient from acting out a dangerous delusion, then a prescription for an anti-psychotic can be a blessing, Doraiswamy says.Also see,
"But a lot of doctors don't realize how powerful these drugs are," Doraiswamy says. "They should be used only as a last resort."
Abnormal Thyroid Levels Can Increase Risk For Alzheimer’s Disease in Women
where I discuss how hypothyroidism can present as dementia andOveruse Of Antipsychotics Among Nursing Home Residents With Dementia
where I discussed this issue and how it related to my mother and her treatment by a personal physician.Alzheimer's drugs double death risk in elderly
The Associated PressAnti-psychotic drugs commonly used to treat Alzheimer's disease may double a patient's chance of dying within a few years, suggests a new study that adds to concerns already known about such medications.
"For the vast majority of Alzheimer's patients, taking these drugs is probably not a worthwhile risk," said Clive Ballard, the paper's lead author, of the Wolfson Centre for Age-Related Diseases at King's College London.
"Would I want to take a drug that slightly reduced my aggression but doubled my risk of dying? I'm not sure I would," Ballard said.
The research was published Friday in the medical journal, Lancet Neurology.
Alzheimer's disease is the most common cause of dementia and causes symptoms including aggression, delusions and hallucinations. Previous studies have shown anti-psychotic drugs, which can help control the aggression and hallucinations for a few months raise the risk of death in older patients with dementia. There are other side effects, including respiratory problems and stroke.
Ballard and colleagues followed 165 patients aged 67 to 100 years with moderate to severe Alzheimer's disease from 2001 to 2004 in Britain. Half continued taking their anti-psychotic drugs, which included Risperdal, Thorazine and Stelazine. The other half got placebos.
Of the 83 receiving drugs, 39 were dead after a year. Of the 82 taking fake pills, 27 were dead after a year. Most deaths in both groups were due to pneumonia.
After two years, 46 percent of Alzheimer's patients taking the anti-psychotics were alive, versus 71 percent of those not on the drugs. After three years, only 30 percent of patients on the drugs were alive, versus 59 percent of those not taking drugs.
Drugs given to up to 60 percent of patients
In the United Kingdom and the United States, guidelines advise doctors to use anti-psychotic drugs cautiously and temporarily. But in many nursing homes in Europe and North America, up to 60 percent of patients with dementia are routinely given the drugs for one to two years.
"The drug regimen for any person with Alzheimer's needs to be personalized," said William Thies of the Alzheimer's Association in the U.S. Thies was not connected to the study. "At some points, some people will be better off with no medication."
Simon Lovestone of the Institute of Psychiatry at King's College in London said psychiatrists should try environmental or behavioral therapies instead of anti-psychotics.
Experts aren't sure how the anti-psychotics increase patients' risk of dying. But they think the drugs could be damaging to the brain and their sedative effects make patients less able to exercise and more susceptible to deadly infections.
The study was paid for by the U.K. Alzheimer's Research Trust. Ballard reported receiving grants from various pharmaceutical companies which make drugs used to treat Alzheimer's patients.
Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
URL: http://www.msnbc.msn.com/id/28566249/
Popular articles on the Alzheimer's Reading Room
- Advice and Insight -- Alzheimer's Reading Room
- Communicating in Alzheimer's World
- Worried About Alzheimer's Disease -- You Should Be
- Dementia and the Eight Types of Dementia
- Does the Combination of Aricept and Namenda Help Slow the Rate of Decline in Alzheimer's Patients
- Test Your Memory (TYM) for Alzheimer's or Dementia in Five Minutes
- Dimebon Connection Study
- The Metamorphosis of This Alzheimer's Caregiver (Part One)
- The Mini-Cog Test for Alzheimer's and Dementia
- Is it Really Alzheimer's or Something Else?
- Alzheimer's Wandering Why it Happens and What to Do
- 60 Good Reasons to Subscribe to the Alzheimer's Reading Room Now
- Urinary Incontinence -- How We Beat Alzheimer's Incontinence
Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,050 articles with more than 8,000 links on the Internet. Bob resides in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room
