According to a new report, side effects of antipsychotics, such as Seroquel, Zyprexa, Risperdal and Abilify, could be responsible for as many as 1,800 deaths and 1,620 strokes each year among the elderly with dementia in the United Kingdom.
The report, which was commissioned by the British government, found that the use of antipsychotics for dementia has been largely ineffective, resulting in improvement in only 20% of patients. As a result of the findings, the U.K. Department of Health has initiated plans to reduce the use of atypical antipsychotic drugs like Zyprexa, Risperdal, Abilify and Serquel for dementia in its own health system, and hopes that the reduction will be picked up by other nations as well.
There are an estimated 180,000 elderly people with dementia in the United Kingdom currently being treated with the antipsychotic drugs, according to the report’s author, Professor Sube Banerjee. However, only 36,000 were found to derive any benefit from the drugs.
“The findings of my review confirm that there are indeed significant issues in terms of quality of care and patient safety,” said Banerjee, professor of mental health at King’s College London Institute of Psychiatry, in a letter to the Minister of State that accompanied the report. “These drugs appear to be used too often in dementia and, at their likely level of use, potential benefits are most probably outweighed by their risks overall.”
Banerjee recommends that the British government reduce the use of Zyprexa, Risperdal, Abilify and Seroquel in dementia patients by two-thirds, which he says can be done within 36 months. The British government has accepted Banerjee’s recommendations, and plans to create a new federal position for a National Clinical Director for Dementia to oversee the reduction of the use of antipsychotics and the proper treatment of dementia across the country.
In the United States, many of the antipsychotics prescribed to treat dementia, such as Seroquel, are not approved for that use by the FDA. This means that drug manufacturers are not supposed to market the drugs for dementia treatment, but doctors are not restricted from prescribing them. However, ongoing litigation against AstraZeneca over Seroquel produced internal documents that suggested that the company was promoting the antipsychotic drug for off-label uses, including dementia, illegally.
In 2005, the FDA required antipsychotics to carry a “black box” warning that the drugs were connected to an increased risk of premature death in elderly dementia patients. The warning is the most stringent labeling requirement possible under federal law.
In late October, the Chicago Tribune conducted an investigation and found that similar over prescription problems with antipsychotics occurred in the United States, particularly in nursing homes. An analysis of medical data from 275,000 residents with dementia found that they were more likely to suffer a nursing home fall or decline in health when prescribed antipsychotics or other psychotropic drugs. Two-thirds of all nursing homes in Illinois were cited at least once in the past eight years for violating drug use laws regarding such drugs, the investigation found.