Today I am responding to a Huffington Post article viewed this morning and written by Anthonia Akitunde with respect to antipsychotic drugs which have been found to be unsafe and ineffective for older adults. Huffington Post author shares the more recent findings on antipshychotic drugs below:
Researchers from the University of California, San Diego and the University of Iowa observed the effects of atypical antipsychotics (Abilify, Zyprexa, Seroquel, and Risperdal) on 332 patients over the age of 40. (These patient all suffered from psychosis caused by dementia, schizophrenia and post traumatic stress and mood disorders.) In the study's first year, one-third of participants experienced metabolic syndrome which includes a number of factors - such as insulin resistance and abdominal weight gain - increasing the risk of heart disease and diabetes. After two years, "nearly a quarter of the patients developed serious adverse effects and just over half developed non-serious adverse effects," according to the study release. According to Dr. Dilip V. Jeste, director of the Stein Institute for Research on Aging at UC San Diego, "The study suggested that off-label use of these drugs in older persons should be short-term, and undertaken with caution. While there were a few significant differences among the four drugs, the overall risk-benefit ratio for the AAPs in patients over age 40 was not favorable, irrespective of diagnosis and drug."
According to the New York Times, 3.1 million Americans were prescribed antipsychotic drugs in 2011 and hundreds of thousands of those persons included elderly patients with dementia. Antipsychotics have been linked to increased risk of death in elderly in past studies yet a recent study found that those with Alzheimer's disease who stop taking Risperdal for agitation and aggression were two times more likely to relapse when put on a placebo than those who continued using the drug. The study found there was no difference between the rate of death or side effects for those who continued taking Risperdal and those on the placebo.
While geriatric dementia patients have been placed on antipsychotic off-label drugs as long as I can remember, many of these same patients also had a dramatic break through in terms of quality of life, especially in those suffering with an Alzheimer's diagnosis. When making home visits to see clients both the nurse and myself noticed a reduction in agitation and a return to quality of life that these clients would not have otherwise. While I am glad there have been recent studies at UCSD, the findings are the same as they were in early 2005 and beyond.
Finally, communication between family, caregivers, and an experienced Geriatric Care Manager working with a client's psychiatrist, reporting any status changes with dementia clients is key. When daily unmanageable crises make it necessary to introduce an alternate treatment method, antipsychotics can sometimes provide the help needed to maintain patient safety and ensure the caregiver's safety as well. This sometimes takes a joint effort of caregivers, nurses and a Geriatric Care Manager monitoring and communicating status updates to clinicians as necessary.
Posted: 20th of March, 2016 by Olga Brunner
Labels: UCSD, antipsychotic drugs, Alzheimers, dementia, geriatric psychiatry, Stein Institute for Research on Aging, Dr. Dilip V. Jeste
I Have worn many hats in my day: Nursing Home Assistant Admin and Activities Director, Assisted Living Admin, Case Management for the State-wide Medicaid Program, and Trainer for Dept of Elder Affairs.