Antipsychotic drugs are overprescribed to dementia patients, according to research by UW associate professor Chris Perlman of the faculty of applied health sciences and UW professor Tejal Patel of the faculty of science.</p>
Antipsychotics are used to treat aggressive behaviours, hallucinations and other symptoms that stem from dementia. However, these drugs also have negative side effects, such as an increased risk of stroke, falls, hypotension, cognitive decline, and even death among individuals with dementia.
“Antipsychotic drugs should not be used as a first line of treatment for individuals with dementia who may be experiencing psychosis or behavioural symptoms. They should be considered as a last resort,” Perlman said.
The research found a high prescription rate of these drugs, even in patients who exhibited no symptoms or behaviours that the medicine would normally treat. The use of the medication was common within each of the health sectors the researchers looked at.
Although these medications are correctly used to treat symptoms of psychosis which may be experienced by patients with dementia, Perlman believes antipsychotic drugs are prescribed inappropriately to treat a host of symptoms of dementia that may be managed using other forms of care.
“While these medications may be helpful in the short term for these behaviours, their use to manage such behaviours is not warranted,” Perlman said. “It is also suspected that these medications are being used inappropriately to treat other symptoms of dementia such as restlessness and insomnia.”
Statistics released by Perlman indicated the prevalence of the problem. Of those suffering from dementia over the age of 65, the study found that 14 per cent of patients who receive home care were prescribed the antipsychotic medications. Twenty seven per cent in acute care hospitals had been given the medicine, along with 30 per cent in continuing care hospitals and 35 per cent in long-term care facilities around the province.
Perlman believes that there is a need to change the structure of the available health and social services and educate caregivers and family members on supporting people with dementia.
“Allowing providers to have the time to get to know each person, their interests, and life history, might help them structure activities and care in ways that are more familiar to the person,” Perlman said. “Also, having structured social programs available for individuals with dementia, where they can engage in activities that are positive and meaningful to them, might also help the person have quality of life free of agitation and restlessness.”
