Despite strict government warnings and national initiatives cracking down on administering antipsychotic drugs to older people with Alzheimer’s disease and other dementia, dangerous abuses persist. The practice is particularly pernicious when it occurs in nursing homes, behind closed doors, where the most vulnerable residents are rarely informed or allowed to give meaningful consent before being drugged.
alert after analyzing the continued overuse of antipsychotics in nursing homes. It found that in 2016, more than 270,000 nursing home residents are still being liberally drugged with them even though the overwhelming majority of them have not been diagnosed with any type of psychosis. The Center decried it as elder abuse and “a national scandal.”
Nursing home residents are medicated in alarming degrees with alarming doses of anti-depressants, anti-anxieties, antipsychotics, sedatives, and hypnotics—all belonging to the family of “psychoactive” drugs, also called anti-psychotics, psychotropics, or psychotherapeutics. Whatever their label, they work on the brain in various ways to change a person’s mood, behavior, or personality. Most of them also decrease the level of consciousness, acting as a type of “chemical restraint.”
While there are justifiable and therapeutic uses for these drugs, particularly for individuals with bipolar disorder or schizophrenia, they’re frequently misused and abused in nursing homes, where a majority of the residents are prescribed one or more of them, usually to calm those who are agitated or combative—and considered problematic patients.
But the powerful drugs, acting alone and in interaction with other drugs, have a long list of common side effects—including tremors, anxiety, confusion, insomnia, immobility, delirium, kidney and heart failure, and violent behavior. Another common effect, oversedation, often greatly increases the risks of falls and fractures. And in some people, those diagnosed with Alzheimer’s and other types of dementia, psychoactive drugs can even cause death.
Ignoring the Warnings
The risk is so real that in 2005, the Food and Drug Administration (FDA) issued warnings to prescribers and distributors and then imprinted the drugs with one of its rare black box warnings.
*Elderly patients with dementia-related psychosis treated with conventional or atypical antipsychotic drugs are at an increased risk of death.
*Antipsychotic drugs are not approved for the treatment of dementia-related psychosis.
Furthermore, there is no approved drug for the treatment of dementia-related psychosis. Healthcare professionals should consider other management options.
Perversely, however, the use of such drugs in care facilities actually increased after the FDA’s dire warning.
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Nursing Home Residents With Alzheimer's Drugged to Death