Australian experts say over-prescription of powerful antipsychotic drugs for dementia patients may be leading to as many as 6,000 premature deaths in that country’s nursing homes each year. The drugs — including older medicines like Haldol and the newer “atypicals” Risperdal, Seroquel, Zyprexa, and Abilify — are often used unnecessarily to keep residents suffering from dementia and Alzheimer’s docile for the convenience of overworked staff.
But the drugs can increase the risk of death by 50 per cent, and family members are often ill informed about their use, the Australian news program Lateline reports. The drugs are administered, often in high doses, to deal with the restlessness, agitation, and inappropriate behavior that are part of dementia. But the drugs can leave patients immobilized, unresponsive, unable to speak, and at great risk of strokes and death.
Experts interviewed by Latelinesay that antipsychotics are not beneficial for the vast majority of dementia patients whose behavior can often be managed by better-trained staff. Professor David Le Couteur of the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists said there is “evidence that stopping those medications improves those outcomes, improves their behaviour and improves their cognition.” Professor Le Couteur says that in many cases doctors are prescribing these drugs in order to make life easier for caregivers and health care workers.
In the United States, the Food and Drug Administration (FDA), recognizing the overuse of anti-psychotics in nursing homes, just completed a two-year effort that reduced use of anti-psychotics among elderly nursing-home residents. Still, the effort fell short of the government’s goal of a 15 percent reduction by the end of 2012, the Wall Street Journalreports.
The reduction effort was in response to fear of the risks that antipsychotic drugs pose to dementia and Alzheimer’s patients. In addition, these drugs are costly to the Medicare program, which reportedly spent $7.6 billion on this class of drugs in 2011, according to the Centers for Medicare and Medicaid Services (CMS).
Critics of the widespread use of antipsychotics say government regulators need tougher oversight, according to theWSJ. The FDA imposed its strongest warning label – a “black box” – in 2005 on all atypicals, saying that elderly patients with dementia face an increased risk of death from the drugs. “These drugs are estimated to increase risk of death by 60% to 70% in elderly patients with dementia, based on results of 17 randomized clinical trials enrolling more than 5,000 patients,” said Stephen Crystal, a health researcher at Rutgers University.