Is there a risk in using antipsychotic medications for people with dementia?
Guest post by Laura Woods
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.
Laura Woods writes primarily about emerging pharmaceutical litigation and other legal news concerning consumer rights and patient safety. She holds a Master of Business Administration degree and is currently a professional freelance writer for several health, legal, and medical websites. You can read more of Laura’s work on Risperdal at Injury Lawyer News.
(Slightly edited. The Caregiver’s Voice Ed.)
Brenda, thanks and I apologize for the spelling errors. It was 6 AM when I was writing and I was tired. But, when I saw this article I had to read it and comment. I have to be a little more determined when talking to the doctor.
Very good information. I am so pleased to see this from other then my mouth or the research for side effects I do all the time.
I tried to convince the Neurologist that my wife, who is 72 and had Lewy Body dementia with Parkinsonism, should not be on Seroquel.
I will take this article with me on Nov 11 and see what feedback I get.
She is starting to have problems of falling asleep even while walking–that is a side effect of Sinemet 25/100 but the Seroquel could be part of the cause, too. She does hallucinate and has speech problems.
I keep blaming the medicines as I refuse to believe she is in the last stages of these diseases. I have brought this up only to be told the standard statements of “It’s the progression of the disease” or “The Benefits outweigh the risks.”
Don, I believe as a primary caregiver, you know best what Marie’s condition is and what she needs.
Be gentle yet determined when describing symptoms to the doctor and engage him to discuss options.