Dementia patients twice as likely to die if they take certain drugs, researchers warn
Elderly people in nursing homes with dementia run double the risk of dying from certain ‘chemical cosh’ drugs, warn researchers.
Alarm bells have been sounded about the dangers of premature death caused by antipsychotic drugs in recent years, but a new study shows some are more risky than others.
It found people over 65 taking haloperidol had double the risk of death compared with those taking a newer drug called risperidone.
A study has found that people over 65 taking haloperidol, pictured, had double the risk of death compared with those taking a newer drug called risperidone
Those taking highest doses of antipsychotic drugs – often known as the ‘chemical cosh’ because they are wrongly used to sedate elderly patients – were at greatest risk.
The Harvard Medical School study, the largest ever undertaken among US nursing home residents, looked at 75,445 older nursing home residents between 2001 and 2005.
The drugs investigated in the study are all used in nursing homes and on general hospital wards in the UK.
A Government-commissioned review in 2009 found 180,000 people with dementia were prescribed antipsychotics, of which 144,000 were given them inappropriately.
Research suggests this could mean 23,500 people dying prematurely each year.
Haloperidol, which was originally licensed for schizophrenia and other psychiatric conditions, is one of the oldest used, while newer antipsychotics include risperidone and quetiapine.
A Government-commissioned review in 2009 found 180,000 people with dementia were prescribed antipsychotics, of which 144,000 were given them inappropriately
In the six-month study published in bmj.com – the online edition of the British Medical Journal – researchers found 6,598 nursing home residents died, almost nine per cent.
Patients treated with haloperidol had double the risk of death compared with those taking risperidone, the most commonly prescribed drug which was used for comparison with the other five drugs.
The effect of haloperidol was strongest in the first 40 days of treatment, while those taking quetiapine (sold under the brand Seroquel) had a slightly reduced risk of death.
There was no significant effect on death rates from the other drugs, aripiprazole, olanzapine (marketed as Zyprexa) and ziprasidone.
Almost half of deaths were recorded as due to circulatory disorders, 10 per cent due to brain disorders and 15 per cent to respiratory disorders.
The experts concluded ‘The data suggest that the risk of mortality with these drugs is generally increased with higher doses and seems to be highest for haloperidol and least for quetiapine.’
The Daily Mail has long called for an improvement in the care of dementia sufferers as part of our Dignity for the Elderly Campaign.
Manchester University academics earlier this week found more than a quarter of elderly patients with dementia were receiving antipsychotics, sometimes for years even though they are supposed to be used for a few weeks at most.
Most antipsychotic drugs are not licensed for treatment of dementia but are frequently prescribed to control agitation and aggressive behaviour, making life easier for carers and nursing home staff.
But Dr Anne Corbett, research manager at the Alzheimer’s Society charity, said the practice must stop.
She said ‘This research supports existing studies that have shown antipsychotics can raise the risk of death, particularly when used over the longer term.
‘As many as 150,000 of the 180,000 people with dementia who are on the drugs in the UK have been prescribed inappropriately. For a minority of people with dementia antipsychotics should be used, but then only for up to twelve weeks, and under the correct circumstances.
‘People with dementia are currently having their lives put at risk because of dangerous antipsychotic medication. Too often we hear about an over-reliance on medication as a response to distressed reactions of people with dementia, when a person-centred approach is what is required.
‘This needs to stop now. There has been some progress but good care rather than antipsychotics must become the norm. Staff need to be trained and supported to be empowered to provide person-centred care.’