Antipsychotics as Nursing Home Chemical Restraints Continue: Report

Despite warnings that indicate antipsychotic drugs can cause fatal side effects for certain elderly users, a new report suggests that nursing homes nationwide continue to routinely give residents the medications as a form of “chemical restraint” to keep them passive and docile. 

According to special report by the Boston Globe, an estimated 185,000 nursing home residents nationwide were prescribed antipsychotic medications in 2010, even though they had none of the conditions for which the drugs have been approved to treat.

The widespread overuse of antipsychotic medications, such as Risperdal, Seroquel, Zyprexa and Abilify, continues despite warnings issued by the FDA and other health experts indicating that the drugs should not to be used to treat patients with Alzheimer’s disease and dementia, because they may increase the risk of death for individuals with those conditions.

Part of a class of medications known as atypical antipsychotics, the drugs are approved to treat a number of mental health problems, such as bipolar disorder and schizophrenia. However, they are also widely used “off-label” for ailments that have not been approved by the FDA, because the manufacturers have not established that they are safe or effective for those conditions.

Nursing home officials have suggested that they are giving the drugs to some elderly residents to prevent them from harming themselves and others, but health experts say that the drugs place the elderly residents in a stupor, increasing the risk of nursing home falls and other problems. The chemical restraints also lower their quality of life by leaving them in a perpetual state of mind-numbed sedation, causing many to consider the use of the drugs in these situations to be a form of nursing home abuse.

Last May, the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG) issued a report on atypical antipsychotic misuse in nursing homes, which found off-label and dangerous use of the drugs was widespread.

The HHS-OIG report took data collected by the U.S. Centers for Medicare and Medicaid Services (CMS) in the first half of 2007 and found that 14% of the nation’s 2.1 million elderly nursing home residents were prescribed atypical antipsychotics at least once. Medical records indicate that 83% of those drugs were given for “off-label” reasons which were not approved by the FDA.

About 88% of the off-label uses were for conditions that the FDA cautioned against in black box warnings, the strongest label advisory the agency can give. The FDA warnings date back to 2005.