Veel ongewenste doden onder Alzheimer patiënten door antipsychotica*
Uit een Engelse studie blijkt dat in Engeland jaarlijks 23.000 Alzheimer patiënten vroegtijdig sterven als het gevolg van antipsychotica. In verzorgingstehuizen krijgen patiënten met de ziekte van Alzheimer vaak ten onrechte antipsychotica als kalmerende middelen toegediend wanneer zij onrustig zijn of neigen tot agressie.
Ten onrechte omdat het "off-label" gebruik is van deze medicijnen
zoals bijv. haloperidol
of risperidone
die
hiervoor niet bedoeld zijn. In de studie bleek dat na 2 jaar antipsychotica nog slechts 54,8% van de
patiënten leefden tegen 78% van de patiënten zonder psychotica. Na 3,5 jaar was dit resp. 28% en 60%. In Engeland komt dat neer op jaarlijks 23.000
mensen die vroegtijdige doodgaan.
23,000 Alzheimer's Patients Killed Each Year in the U.K. by Psych Drugs
More than 23,000 Alzheimer's disease patients are killed in the United Kingdom each year due to "off-label" use of anti-psychotic drugs, according to a report issued by Liberal Democrat Minister Paul Burstow.
"There are around 244,000 people with dementia living in care homes," Burstow said, "and the Alzheimer's Society estimates 100,000 are being given anti-psychotic drugs. Of those, I am saying that 23.5 percent could be dying prematurely as a result of being prescribed anti-psychotic drugs - or 23,500 people a year."
Anti-psychotic drugs such as chlorpromazine, haloperidol, thioridazine, trifluoperazine and risperidone are designed to treat the delusions or hallucinations caused by schizophrenia or bipolar disorder, and are not authorized for use on patients with Alzheimer's or other forms of dementia. But due to their sedative effects, they are commonly used on nursing home patients, especially those who have a tendency toward agitation or aggression. Dubbing the drugs a "chemical cosh," patient advocates have accused care home staff of sedating patients with potentially dangerous drugs just to make life easier for
themselves.
"The over-prescription of anti-psychotic drugs to people with dementia is a serious abuse of human rights," said Neil Hunt, chief executive of the Alzheimer's Society. "Anti-psychotics should be used as a last resort."
Burstow's mortality numbers were derived from a study led by Clive Ballard from King's College London. Ballard and colleagues found that Alzheimer's patients who were treated with anti-psychotics had a significantly higher rate of death than those given a placebo. After 24 months of treatment, only 54.8 percent of the anti-psychotic group was still alive, compared with 78 percent of the placebo group. By 42 months, the survival rates had dropped to 28 percent in the anti-psychotic group and 60 percent in the placebo
group.
Prior research by Ballard found that when dementia patients were taken off of anti-psychotics, they demonstrated less trouble thinking and communicating than those who were not taken off the medication. These findings have been backed up by other studies, which have also found that patients taken off of anti-psychotics do not become any more aggressive. Still other research has concluded that Alzheimer's patients on anti-psychotics have three times the risk of stroke and twice the risk of death as patients not being given the drugs.
In spite of this research and the fact that anti-psychotics are not approved for dementia patients, the use of the drugs on people over the age of 60 - primarily dementia patients - has increased by nearly 40 percent in the last few years. Burstow accused the government of failing to act decisively to stem this
practice.
The use of anti-psychotics for dementia falls into a gray area of the law. Although British health guidelines do not allow the use of anti-psychotics as a sedative, doctors are allowed to use the drugs if they decide they are necessary.
"Using drugs to restrain vulnerable older people with dementia is no different to strapping them to a chair," he said. "It is an abuse of their human rights. Ministers are guilty of being complacent. There should a ban on prescribing anti-psychotic drugs in all but the most severe cases of dementia."
"There are human alternatives," Burstow added. "They demand more training and support, but they work."
According to Hunt, proper training of nursing home staff can decrease the use of drugs by 50 percent.
Burstow also called for immediate police action to halt the practice of sedating elderly patients.
"Inappropriate or abusive prescribing is not just sedating older people, it is killing them. The law makes it clear: Treatment without consent is assault. It is time the police and the courts took abuse of elderly people
seriously." (December
2008)