Doctors are discouraging prescribing antipsychotics to patients with dementia after the largest study of its kind found that they were associated with more harmful side effects than previously thought. asked to reduce it.
These powerful drugs are widely prescribed for the behavioral and psychological symptoms of dementia, including apathy, depression, aggression, anxiety, irritability, delirium, and psychosis. Tens of thousands of people with dementia are prescribed them each year in the UK.
Safety concerns have previously been raised about the drug, with doctors being warned based on an increased risk of stroke and death, but evidence of other risks was inconclusive. .
New research suggests that the range of harms associated with its use is considerably broader than previously acknowledged in regulatory warnings, and calls for greater attention in the early stages of treatment. One thing is emphasized.
Antipsychotic drug use in people with dementia is associated with an increased risk of a wide range of serious adverse outcomes, including stroke, blood clots, heart attack, heart failure, bone fractures, pneumonia, and acute kidney injury, the study authors reported. . Their findings were published in the BMJ.
Charles Marshall, professor of clinical neurology at Queen Mary University of London, who was not involved in the study, said: “This evidence should prompt new efforts to reduce the prescribing of antipsychotics to people with dementia.” said.
“Although there are rare situations where antipsychotics are truly needed and the benefits outweigh the risks, for the majority of patients with behavioral symptoms that may lead to antipsychotic prescription, there are safer We need to focus on behavioral management approaches.”
The study looked at data from 174,000 adults registered with UK GPs who were diagnosed with dementia between 1998 and 2018.
During the study period, 35,339 people (63% of whom were women) were prescribed antipsychotic drugs, and their medical records were compared with those of dementia patients who were not prescribed these drugs.
Academics from the Universities of Manchester, Nottingham, Edinburgh and Dundee found that people with dementia who took antipsychotics were twice as likely to develop pneumonia as those who did not. .
Researchers also found that people with dementia who took antipsychotics had a 61% increased risk of stroke and a 43% increased risk of bone fractures. Also, the risk of heart attack increased by 28%, and the risk of heart failure increased by 27%.
Dementia patients prescribed antipsychotics appear to have a 72% increased risk of kidney damage and a 62% increased risk of developing a type of blood clot called venous thromboembolism. The increased risk appeared to be highest during her first week after treatment.
Because this study was observational, no firm conclusions could be drawn about cause and effect. However, the authors wrote that “the range of adverse outcomes was broader than previously highlighted in regulatory warnings, with the highest risks occurring immediately after treatment initiation.”
The study's lead author, Professor Darren Ashcroft from the University of Manchester, said: “More people with dementia are being prescribed antipsychotics in recent years, despite existing regulatory safety warnings. It has become clear,” he said.
“It is important to carefully weigh the potential benefits of antipsychotic treatment against the risk of serious harm, and treatment plans should be regularly reviewed in all medical and care settings.”
Commenting on the study, Dr Shena Scales, director of research at the charity Alzheimer's Research UK, said the findings suggest the risks may be more serious than previously known, adding: This is particularly concerning given the increasing use of
Dr Tom Russ, Honorary Consultant Psychiatrist at the University of Edinburgh, said: 'This study does not suggest to me that these drugs should never be used, but it does suggest that other methods are being considered. It should be used sparingly in situations where