Antipsychotics Linked to Increased Risk of Death for Alzheimer’s Patients
Published: January 13th, 2009 • One Comment
New research suggests that the use of antipsychotic drugs to manage dementia associated with Alzheimer’s disease nearly doubles the patient’s risk of death.
Alzheimer’s disease is an incurable brain condition which causes the progressive deterioration of brain tissue, leading to a decline in cognitive and motor skills over time.
Antipsychotic drugs are often used to alleviate dementia symptoms associated with Alzheimer’s, such as agitation, aggressive behavior or psychotic episodes in which the patient may harm themselves or others.
A study published last week online by The Lancet Neurology, finds that Alzheimer’s patients given antipsychotic medications are at a much higher risk of dying prematurely than those who are not given the drugs.
British researchers evaluated 165 nursing home Alzheimer’s patients who were given either a placebo or one of four antipsychotics, including Risperdal, haloperidol, chlorpromazine or trifluoperazine. Although there was no difference in death rates at six months, researchers found that the number of deaths was substantially higher after one year.
At one year, researchers found that 70% of those treated with antipsychotics were alive, compared with 77% of those on a placebo. The numbers began to spike at two years, with 46% of those on antipsychotics still alive, compared with 71% of those on placebos. By the three year point, only 30% of those on antipsychotics were still alive, compared with 59% of those on placebos.
Elder care experts have indicated that antipsychotics are often unnecessary for management of most Alzheimer’s patients, as proper staffing and training can avoid the need for the drugs.
Antipsychotic medications currently carry a “black box” warning required by the FDA about an increased risk of death, yet about half of all long-term care and nursing home residents with dementia continue to be treated with the medications.
Clive Ballard, M.D., lead author of the study, and the other researchers from King’s College London indicate that doctors should attempt to use safer treatments to manage Alzheimer’s dementia, such as psychological management, Namenda (memantine) or antidepresants like Celexa (citalopram).
An editorial that accompanied the study in The Lancet Neurology indicated that there is an “urgent need to review current practices and promote alternative approaches to care for people with dementia.”
Comment by Margaret on 19 November 2009:
My mother was put on this drug in 1999 after a brief “Extremely anxious/psychotic episode) initially 3mg reduced to 1mg. In 2005 she had to go into a Care Home because she gave up walking due to arthritis. Initially she was in emergency respite care and after a place was found for her in a care home nearer to home she began to walk again. As she was 89 and Social Worker said the Day Centre would have to do a full assessment before allowing her to attend again and this could take some time we admitted her into her current care home. After about a month the Care home owner increased her dose back to 3mg – she was always prescribed between 1 – 3mg. When I found out about this after my mother collapsed and thus broke her left hip I asked the Care home owner to reduce the dose but she was adamant not too saying my mother was at risk of having a fall! I argued that I wanted her to discuss this with the GP (they changed her GP the day she was admitted to the home). She didn’t discuss with GP. I spoke to the Deputy Manager about my concerns of my mother being on this high dose and she said they would have to review with GP so I asked them to do this. They didn’t. After a recent hospitalisation with another UTI I discovered my mother was still being given 3 mg of Trifluoperazine so I approached the GP direct. He agreed to reduce the dose to 2mg and for me to report my findings (I visit my mother every day). In the 4 years she has been at the home I don’t feel this medication has been properly reviewed by the GP and my mother certainly hasn’t had any psychiatric input whilst at this home.