Dementia Patients Often Get Harmful, Expensive and Unnecessary Drugs: Study

More than half of all dementia patients in the United States appear to be given drugs that are not helping them, according to the findings of new research, which suggests that the medications are not only expensive, but may expose elderly patients to serious health risks. 

In a study published last week in the medical journal JAMA Internal Medicine, researchers from the Indiana University School of Medicine identified a large number of drugs that are commonly prescribed to dementia patients, even though they may do more harm than good.

Researchers conducted a study of medications used by nursing home residents with advanced dementia between October 1, 2009 and September 30, 2010, gathering information on 5,406 individuals in 460 different facilities.

According to the findings, 54% of nursing home residents with advanced dementia received medications of “questionable benefit.”

Researchers also found that patients with eating problems, a feeding tube or with a do-not-resuscitate order were less likely to receive the drugs. However, if a facility overall had a high level use of feeding tubes it increased the risk.

Aricept, Namenda Identified as Questionable Benefit Drugs

The most commonly used drugs with questionable benefits are cholinesterase inhibitors, such as Aricept, and the dementia drug Namenda.

In 2012, the FDA rejected a bid to issue an Aricept recall for the 23mg dose version of the drug. The petition was put forward by the consumer watchdog group Public Citizen, which warns that the Alzheimer’s drug’s benefits were questionable when compared to its low dose version and that it could potentially increase the risk of serious side effects.

Aricept (donepezil) is an acetylcholinesterase inhibitor, which is sold by Pfizer and Eisai, Inc. High doses of Aricept have been linked to a number of potential health risks, including lowered pulse, nausea, vomiting, diarrhea, urinary incontinence, fatigue, dizziness, agitation, confusion and anorexia. However, the group claims that there are little clinical benefits from using the higher doses over the lower ones. –

The drugs costs patients about $272 a month, but the study did not look into whether those costs were paid by the individual, Medicare, or other providers.

“Our findings have important implications because the use of prescription medications in patients with advanced illness presents a burden to the health care system and to patients,” researchers said in their conclusions. “At an economic level, the use of questionably beneficial medications accounts for a significant portion of the average resident’s annual medication expenditure.”

Chemical Restraints in Nursing Homes

In recent years, there has also been increasing concerns over the use of medications as a form of chemical restraint for nursing home patients with dementia, who may be more difficult for nursing home staff to mention.

Atypically antipsychotic medications, such as Risperdal, Seroquel and Zyprexa, have been identified often as forms of chemical restraint, which is often considered a form of nursing home abuse.

The FDA has warned that use of atypical antipsychotic drugs among dementia patients may pose serious health risks, increasing the risk of death without providing any substantial benefit for the patient.

The Department of Justice (DOJ) has previously accused Johnson & Johnson of engaging in kickback schemes designed to convince doctors to prescribe their antipsychotic medication Risperdal to elderly nursing home patients, knowing that the drug was being used abusively and potentially placing patients’ at risk of death.

In November 2013, Johnson & Johnson agreed to pay $2.2 billion to the federal government to settle its Risperdal illegal marketing claims.