Antipsychotics given for dementia pose risks: study

Elderly dementia patients prescribed antipsychotic drugs are at three times the risk of a serious health problem or dying within a month of treatment, compared to those not given the drugs, Canadian researchers said on Monday.

The medications have been used by doctors to treat aggression in people who are not psychotic or schizophrenic, but there are risks for elderly dementia patients prescribed the drugs, according to Dr. Paula Rochon of the Institute for Clinical Evaluative Sciences in Toronto, and colleagues.

"Of residents newly admitted to a nursing home, 17 percent are started on antipsychotic drugs within 100 days of their admission," often for short periods to control delirium, delusions or aggressive behavior, Rochon wrote.

"Antipsychotic drugs should be prescribed with caution even for short-term therapy," she concluded in the report published in the Archives of Internal Medicine.

Three years ago, the U.S. Food and Drug Administration required warnings on antipsychotic drugs notifying patients and doctors of the risks of heart problems or infections in elderly dementia patients.

Previous research has suggested the drugs cause dry mouth and difficulty swallowing, which can lead to pneumonia. Side effects such as dizziness can increase the risk of falls.

The seven-year study of more than 40,000 people age 65 or older -- half in nursing homes -- found 5.2 percent of the nursing homes residents died within a month of being given one of the newer class of so-called atypical antipsychotic drugs.

By comparison, 3.3 percent of residents who did not take the drugs died within a month. Among community-dwelling patients, nearly 14 percent taking the drugs suffered a "serious health event" within 30 days, compared to about 4 percent not on the drugs.

Atypical antipsychotic drugs, which the study said had been available for about a decade, include risperidone, marketed by Johnson & Johnson as Risperdal; olanzapine, made by Eli Lilly and Co under the brand name Zyprexa; and quetiapine, sold by AstraZeneca Plc under the brand name Seroquel.

An older class of "conventional" antipsychotic drugs that includes haloperidol, marketed by Johnson & Johnson as Haldol, posed even higher risks -- four times the risk -- of serious health problems or death, the study found.

Source: Thomas Reuters 2008
Reported by Andrew Stern; Editing by Michael Conlon and Eric Walsh

Source: http://www.reuters.com/

Comments: Antipsychotic drugs are commonly used to treat some of the behavioral complications of dementia, including delirium. According to this recent report in the Archives of Internal Medicine, older adults with dementia who receive short-term courses of antipsychotic medications are more likely to be hospitalized or die within 30 days of the treatment, than those who do not receive the drugs. Yet the shocking fact noted by authors is that 17 percent of the elderly in nursing homes are started on some type of antipsychotics within 100 days of their admission. The nursing home staff uses these medications to treat aggression in people who are not even psychotic or schizophrenic. Three years ago, the U.S. Food and Drug Administration required warnings on antipsychotic drugs notifying patients and doctors of the risks of heart problems or infections in elderly dementia patients.

Another study has also proven that these drugs cause dry mouth and difficulty swallowing, which can lead to pneumonia; side effects such as dizziness can increase the risk of falls. Authors of this study emphasize the fact that with a statement: "Our results exploring serious adverse events likely identify only the 'tip of the iceberg'. Antipsychotic drugs should be prescribed with caution even for short-term therapy." Time and again, such data from nursing homes, hospitals and pharmaceutical companies have shown that each individual has to watch out for his or her own health and cannot rely on others to take care of your health.

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