New research shows drugs that are used to decrease behavioral problems in dementia patients could significantly shorten their lives.
Many patients with Alzheimer's disease and other forms of dementia struggle with symptoms such as hallucinations, agitation, and aggression, the University of Michigan Health System reported. These effects of the degenerative disease are often treated with antipsychotic drugs.
"The harms associated with using these drugs in dementia patients are clear, yet clinicians continue to use them," said lead author and U-M/VA psychiatrist Donovan Maust. "That's likely because the symptoms are so distressing. These results should raise the threshold for prescribing further."
To make their findings the researchers looked at 91,000 American veterans over the age of 65 with dementia. The data from patients who were prescribed antipsychotic drugs was matched with that of similar patients who did not take the medications.
The antipsychotic drugs proved to significantly increase risk of death, and the risk increased along with the dose. The mood stabilizer valproic acid showed a similar influence on death risk as antipsychotics, but antidepressants had only a small effect.
The researchers believe the distress caused by dementia symptoms most likely explains why one-third of adults suffering from the condition and had long-term nursing home stays in 2012 were prescribed these types of antipsychotic medications.
The findings highlight the importance of trying non-pharmacological strategies before prescribing drugs. The problem is these approaches take more time and effort, and their success and application will depend on the support of policy-makers.
"In other words, non-pharmacologic approaches will only succeed if we as a society agree to pay front-line providers for the time needed to 'do the right thing'," said co-author Helen Kales.
The findings were published in a recent edition of the journal JAMA Psychiatry.
