British Legislators Do the Right Thing: The Government must end this needless abuse Antipsychotic Drugging of Elderly

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Telegraph

Stop drugging dementia patients, urges report

April 28, 2008

Ministers should step in to stop inappropriate prescriptions of powerful

antipsychotic drugs for Alzheimer's patients, an influential group of

MPs [Members of Parliament] said today. Up to 105,000 people with

dementia in Britain are wrongly being treated with the drugs, which are

used to control behavioural symptoms such as aggression, they claim.

Research has shown that the medications have side effects which can

accelerate mental decline, triple the risk of stroke, and double the

chances of premature death.

They are intended for psychotic patients suffering from delusions,

paranoia and hallucinations. Yet the drugs continue to be used as a

first resort to address the challenging behaviour of people suffering

from Alzheimer's disease and other types of dementia, according to the

MPs. A report from the all-party parliamentary group (APPG) on dementia

demanded Government action on the problem and urged the National

Institute for Health and Clinical Excellence (Nice), the health

watchdog, to carry out a review.

The report, A Last Resort, points out that no audit or regulation of

such prescriptions exists. , the group's chairman, said:

" Antipsychotics can double risk of death and triple the risk of stroke

in people with dementia, (can) heavily sedate them, and (can) accelerate

cognitive decline.

" The Government must end this needless abuse. Safeguards must be put in

place to ensure antipsychotics are always a last resort. We need to

include families in decisions, give people with dementia regular

reviews, and equip care staff with specialist training. "

The inquiry was told that 150,000 people with dementia were prescribed

antipsychotic drugs in British care facilities. Psychiatric experts said

70 per cent of these prescriptions were inappropriate.

Neil Hunt, the chief executive of the Alzheimer's Society, said more

than 70 per cent of dementia patients exhibited challenging behaviour.

" More often than not this is an expression of unmet need, not a symptom

of dementia, and there is no excuse for reaching for the medicine

cabinet, " he said.

Link:

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/04/28/ndementi

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Letters to the editor: dtletters@...

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BBC News

Members of Parliament urge cut in dementia drug use

MPs have urged the government to stop the " dangerous over-prescribing "

of antipsychotic drugs to people in care homes with dementia.

The All Party Parliamentary Group on Dementia said the drugs should only

be used as a last resort.

Research published earlier this month said the drugs had no benefits,

and could even worsen patients' condition.

Alzheimer's groups said safeguards should be introduced to ensure the

drugs were used only when essential.

There are currently 700,000 people with dementia in the UK, but that

figure is predicted to soar to well over 1.7m by 2051.

The recent study, by experts from Kings College London and Oxford and

Newcastle Universities, found the drugs provided no benefit for patients

with mild behavioural problems, but were associated with a significant

deterioration in verbal skills.

Side effects previously cited include excessive sedation, dizziness

social withdrawal, accelerated cognitive decline and severe sensitivity

reactions.

There have also been suggestions that use of two of the drugs,

risperidone and olanzapine, can increase the risk of stroke.

Five-point plan

The committee looked at the prescription of antipsychotics to care home

residents.

It concluded that around 70% of prescriptions are inappropriate,

equating to around 105,000 people with dementia.

People also often stayed on the medication for far longer than was

necessary, it concluded.

The MPs propose a five-point plan to address the issue for inclusion in

the government's National Dementia Strategy, due to be published later

this year.

Specialist dementia training for all care home staff

Families to be involved in all decisions about giving the drugs

More support for care home staff from GPs, psychiatrists and psychiatric

nurses

Compulsory patient reviews every 12 weeks

A cost-effectiveness review by NICE, the National Institute of Health

and Clinical Excellence and a national audit by the Care Quality

Commission, which supervises care homes MP, chairman of

the group, said: " The government must end this needless abuse and make

the five-point-plan a key element of the strategy.

" Safeguards must be put in place to ensure antipsychotics are always a

last resort. "

He added: " We need to include families in decisions, give people with

dementia regular reviews and equip care staff with specialist training. "

'Deteriorated rapidly'

One carer said the home where his wife resided sent for him because she

had deteriorated rapidly

" We eventually got the GP out and he admitted that he did not know what

to do.

" He suggested that he should ask the consultant to visit and see what he

could do to help my wife. It took five months to get him to visit the

home by which time my wife's health deteriorated.

" When he saw what medication she was on he immediately arranged to have

her taken off all antipsychotic drugs. "

'Serious concerns'

Alzheimer's experts said more than 70% of people with dementia displayed

some form of challenging behaviour at some point, but that it was often

a way of expressing themselves, and so they should not automatically be

offered drugs.

Neil Hunt, chief executive of the Alzheimer's Society, said: " It is

absolutely disgraceful that widespread abuse of people with dementia has

been allowed to continue despite safety warnings on antipsychotics.

Urgent action is needed. "

Wood, chief executive of the Alzheimer's Research Trust, added:

" The report highlights the urgent need to develop better treatments for

Alzheimer's. " With more research funding, we could produce better drugs

that are fit for purpose. "

Ivan , care services minister, said: " The All-Party report raises

issues of serious concern. Inappropriate administration of medication is

entirely unacceptable.

" Guidance to health professionals and care staff is very clear,

antipsychotic drugs should only be used when they are appropriate as

part of best clinical care practice. "

He said the dementia strategy would address the issue of medication and

seek to protect people with dementia from poor professional practice.

The drugs concerned are haloperidol [haldol], chlorpromazine

[thorazine], risperidone [risperdal], olanzapine [zyprexa], quetiapine

[seroquel] and amisulpiride [solian].

Link: http://news.bbc.co.uk/2/hi/health/7366416.stm

Letters here:

http://news.bbc.co.uk/newswatch/ifs/hi/newsid_4000000/newsid_4000500/400

0545.stm

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