Guest post by Laura Woods
Is there a risk in using antipsychotic medications for people with dementia?
Caring for an elderly
person with dementia can be challenging to even the
most patient
caregiver. In addition to memory loss,
people with dementia may
hallucinate, lash out at caregivers, behave in a violent manner, and have
trouble speaking.
Nursing homes often deal with these signs of agitation by treating
people with dementia with antipsychotic medications including Risperdal, Zyprexa,
Seroquel, and Abilify.
However, recent concerns over possible side effects, including confusion,
sedation, and hastened death have raised suspicions on whether these drugs are
causing more harm than good.
The American Psychiatric Association (APA) issued a statement detailing
concerns that need to be addressed for elderly patients taking antipsychotic
medication:
-
Don’t prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring.
- Don’t routinely prescribe two or more antipsychotic medications
concurrently.
- Don’t use antipsychotics as a first choice to treat behavioral and
psychological symptoms of dementia.
- Don’t routinely prescribe antipsychotic medications as a first-line
intervention for insomnia in adults.
Risks of atypical antipsychotics to elderly patients
In April 2005, the
FDA issued a warning to healthcare
professionals that patients with dementia are at an increased risk of death when
treated with antipsychotic drugs. In June 2008, the agency issued a follow-up
warning stating that antipsychotic drugs are not approved for the treatment of
dementia-related psychosis. Physicians prescribing these drugs to patients were
advised to discuss the risk of increased mortality with patients, patients’
families, and caregivers.
Not only do these medications increase the risk of deadly infection and
cardiovascular complications, they can also cause dizziness, a sudden drop in
blood pressure, abnormal heart rhythms, blurred vision, and urinary
problems.
Antipsychotic use for elderly still strong
Despite the risk that drugs like Risperdal pose
for patients with dementia,
federal data indicate that approximately 185,000 nursing home residents received
antipsychotics in 2010, against the recommendations of federal nursing home
regulators.
More than one in five nursing homes in the United States administers
antipsychotics to a substantial portion of residents, although they do not have
a condition that warrants usage.
The U.S. Centers for Medicare and Medicaid (CMS) has been pushing nursing
homes to decrease the use of antipsychotic drugs among elderly residents for the
past two years. CMS hoped to see a 15 percent decrease by the end of 2012.
Instead, from 2011 to 2013, the percentage of nursing home patients prescribed
these drugs dropped by just 9 percent.
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Dementia Signage for the Home
