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Alzheimer’s Antipsychotic Medication Doubles Risk of Death
Antipsychotic drugs commonly prescribed to Alzheimer's patients nearly doubles risk of death over three years, according to new research.
The image demonstrates a pre-clinical Alzheimer's brain top, a mild to moderate Alzheimer's brain in the center, and a severe Alzheimer's brain bottom.
In the study of 165 Alzheimer's patients who were being prescribed antipsychotics, 83 continued treatment and the other 82 were given placebos.
The difference between the two groups became more pronounced over time, with 24-month survival rates for antipsychotic-treated patients falling to 46% versus 71% on the placebo and at 36 months it was 30% versus 59%. It means that after three years, less than a third of people on antipsychotics were alive compared to nearly two thirds using the placebos, demonstrating a significant increase in risk of death for patients who continued taking antipsychotic medication.
As many as 100,000 people with dementia are routinely prescribed antipsychotics in UK care homes and possibly 23,500 people dying prematurely.
Antipsychotics are used to treat symptoms of agitation, delusions and aggressive behavior. NICE (National Institute for Health and Clinical Excellence) guidelines recommend that the drugs should only be used for short periods of time and where symptoms are severe, with very careful monitoring, but in clinical practice the average length of prescription is 1-2 years.
There is evidence of modest short-term (6-12 weeks) benefits of antipsychotic treatment for the serious behavioral symptoms of Alzheimer's, but a previous Alzheimer's Research Trust study showed that these benefits were not evident over longer periods of treatment.
Lead researcher Clive Ballard said: "The results further highlight the need to seek less harmful alternatives for the long-term treatment of behavioral symptoms in Alzheimer's patients. At the moment, there is still a limited place for antipsychotics in the treatment of Alzheimer's, particularly severe aggression, but the serious concerns of the drugs shown by our research emphasize the urgent need to put an end to unnecessary and prolonged prescribing".
Rebecca Wood, Chief Executive of the Alzheimer's Research Trust, said: "The findings of this research are a real wake-up call and underline the danger of prescribing antipsychotics long-term for anything other than exceptional circumstances. We must avoid the use of these drugs as a potentially dangerous 'chemical cosh' to patients who would be better off without it. The study also highlights the urgent need to develop better treatments as Alzheimer's patients have few options available to them.
References:
1. Clive Ballard et al, Dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurology.
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