Antipsychotics Linked to Increased Risk of Death for Alzheimer’s Patients

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.”