Charity condemns costly and dangerous prescribing of anti-psychotic drugs
Published 3 December 2007
The NHS is wasting as much as 80 million pounds on prescribing unnecessary sedative drug treatments to people with dementia, according to the Alzheimer's Society.
Over 100,000 people with dementia are currently being prescribed antipsychotic drugs which research shows have minimal benefit and dangerous side effects.
The charity has called for an end to the widespread drug abuse of people with dementia following a BBC Panorama investigation. The first All Party Parliamentary Group for Dementia has announced an inquiry into the overuse of anti-psychotic medication for the care of people with dementia.
The Alzheimer's Society has argued that money wasted on sedative drugs should be spent on training care home staff to deliver good quality dementia care.
Neil Hunt, chief executive of Alzheimer's Society, says,
'Today is D-Day for dangerous drug prescribing. Sedating a person with dementia should be a last resort but too often doctors are turning to the medicine cabinet without considering the alternatives. Today Panorama is shining a light on the widespread drug abuse of people with dementia, which has been hidden away for too long. The first parliamentary inquiry into the practice is also an important step to uncovering the true scale of the problem, and we look forward to its findings.
Over 100,000 people are being prescribed these drug treatments that leave people with dementia in a zombie like state, robbed of their quality of life. Research shows that anti-psychotics have minimal benefit and drastically increase the risk of death and stroke. It is absurd that we are wasting millions of pounds prescribing these drugs when this money would be much better spent training health professionals in dementia care.
Dementia isn't only about memory loss; more than half of all people with dementia experience behavioural symptoms as part of their condition. Basic dementia training can help staff deal with these symptoms and has been shown to reduce the use of antipsychotics drugs by 50 per cent. This lazy and costly prescribing must stop.'
The Alzheimer's Society is campaigning against the overuse of anti-psychotic drug treatments as part of its putting care right campaign. Last week, a new report highlighted the huge variation in the standard of care that people with dementia receive in care homes and called for mandatory training for all care home staff. Guidelines recommend that people with dementia should only be prescribed sedatives as a last resort, when their symptoms are very severe.
ENDS
For more information, contact the Alzheimer's Society press office.
Notes for editors
- Please Look After Dad is due to be broadcast on BBC1 at 8:30pm on Monday 3rd December
- Professor Clive Ballard, director of research, Alzheimer's Society contributed to the Panorama programme. In the programme he discusses a study "Neuroleptics: do they accelerate cognitive decline and exacerbate neuronal loss?" The study was funded by the Alzheimer's Research Trust and based at King's College London. It began in July 2001 and ran until June 2006.
- 165 participants with Alzheimer's disease living in nursing homes in Oxfordshire, Newcastle, Edinburgh and London, who had been taking neuroleptic drugs for at least 3 months, took part in a long-term randomized double-blind placebo controlled neuroleptic withdrawal trial.The neuroleptics in the study were thioridazine (Melleril), chlorpromazine (Largactil), haloperidol (Serenace), trifluoperazine (Stelazine) and risperidone (Risperdal). Patients continued to take their prescribed neuroleptic drug for 12 months or took a matched placebo.
- Additional follow up was completed a minimum of 12 months after initial enrolment (range 24-54 months) to determine the impact of continuing or discontinuing neuroleptics on mortality. The differences in survival were particularly striking at 24 months (78% v 55%), 36 months (62% v 35%) and 42 months (60% v 25%) The research findings are due to be published in 2008
- More than half of all people with dementia experience behavioural symptoms as part of their condition, including becoming more prone to aggression. Other behavioural symptoms may include restlessness, depression, psychosis, or loss of inhibitions.
- People with dementia experience behavioural symptoms for a number of reasons: maybe as a result of physical discomfort, being unable to understand the world around them, or by damage to the brain that regulates behaviour.
- The National Institute of Health and Clinical Excellence has produced clinical guidelines to encourage good practice in antipsychotic use. The recommendations state that:
- People with Alzheimer's disease, vascular dementia or mixed dementia with severe non-cognitive symptoms may be offered treatment with an antipsychotic drug in the first instance only if they are severely distressed or there is an immediate risk of harm to the person or others. The assessment and care-planning approach, which includes behavioural management, should be followed as soon as possible. If distress and/or agitation are less severe, interventions should be followed before a pharmacological intervention is considered.
- Those with mild to moderate non-cognitive symptoms should not be prescribed antipsychotic drugs due to dangerous side-effects.
- People with Alzheimer's, vascular dementia, mixed dementias or dementia with Lewy bodies with severe non-cognitive symptoms (psychosis and/or agitated behaviour causing significant distress) may be offered treatment with an antipsychotic drug provided certain conditions have been met.
- 1 in 3 older people will end their lives with a form of dementia
- 700,000 people in the UK have a form of dementia, more than half have Alzheimer's disease. In less than 20 years nearly a million people will be living with dementia. This will soar to 1.7 million people by 2051. 1 in 6 people over 80 have dementia.
- The Alzheimer's Society champions the rights of people living with dementia and those who care for them. The Alzheimer's Society works in England, Wales and Northern Ireland
- As a charity, the Alzheimer's Society depends on the generosity of the public to help it care, research and campaign for people with dementia. You can donate now by calling 0845 306 0898 or visiting http://www.alzheimers.org.uk/
- The Alzheimer's Society Dementia Helpline number is 0845 300 0336 or visit http://www.alzheimers.org.uk/.