It has long been a concern that the use of anti-psychotic drugs for elders with Alzheimer’s disease or other forms of dementia was not healthy. These drugs were designed to treat Mental Illness, not the symptoms of Dementia. However, dementia patients often suffer agitation, can be violent, and are hard to calm down. The widespread use of anti-psychotics to treat these symptoms was often just a convenience for caregivers and nursing homes. New research is showing that this may be a bad practice and should be carefully monitored.
Some of the newer drugs show less problems, but the older drugs show an increased incidence of death among the elderly patients who received them. The FDA issued warnings in 2005 about the use of the newer drugs and their association with increased death. However, the study data was preliminary and not definitive. New, larger studies have found more definitive links between these types of medicines and deaths in senior citizens.
“The clinical message is that even short-term use of these drugs can be associated with an increased risk of death, so physicians need to carefully weigh potential risks and benefits of using these drugs to manage symptoms of dementia, and they need to reassess the use soon after they’re initiated to see if they can be safely discontinued,” says Sudeep Gill, MD, MSc, a geriatric medicine specialist and the study’s lead author.
Dr. Gill did not recommend that the antipsychotic drugs never be used in dementia patients. “Sometimes they ease specific symptoms of aggression and hallucination,” he said. “But they are not appropriate for everyday use for everyone with dementia.” Dr. Gill feels that these drugs should not be used if effective non-drug treatments are available.
The study, “Antipsychotic Drug Use and Mortality among Older Adults with Dementia,” is published in the June 5, 2007, issue of Annals of Internal Medicine. The research was funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health and Long-Term Care. Dr. Gill is a geriatric medicine specialist at Providence Care – St. Mary’s of the Lake Hospital and assistant professor of medicine at Queen’s University in Kingston, Ontario. He and his colleagues conducted the research at the Institute for Clinical Evaluative Sciences (ICES), an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues.