US scientists have found certain antipsychotic drugs increase the risk of death in elderly nursing home patients, when compared with other antipsychotics. The study is published in theÂ BMJ online.
Researchers at Harvard Medical School studied medical records from 75,445 people over 65 who were living in nursing homes. They assessed the risk of death in people taking different forms of antipsychotics over six months, using one particular drug â€“ risperidone â€“ as a comparison.
They found that one of the drugs, haloperidol, increased the risk of death when compared with risperidone. Three other treatments â€“ aripiprazole, olanzapine and ziprasidone â€“ showed no significant difference, while the risk of death was reduced in people taking a sixth drug, called quetiapine. The effect for haloperidol was strongest during the first 40 days of treatment, and higher doses increased the risks for all of the drugs except quetiapine.
Previous research has already shown that long-term use of antipsychotics can double the risk of death in patients with Alzhiemerâ€™s disease, but the differences between different antipsychotic drugs have been less well studied. The researchers believe that where doctors feel they need to prescribe antipsychotics to people with dementia, these latest results could help inform their decisions about which drug to give, and what dose.
Rebecca Wood, Chief Executive of Alzheimerâ€™s Research UK, said: â€œThe risks associated with antipsychotics are well-established, and these findings underline the importance of ensuring that where these drugs are prescribed, their use must be carefully monitored. Antipsychotics should only be used for people with dementia where there is no alternative for dealing with challenging behaviour. Alzheimerâ€™s Research UK has called for action to reduce the use of antipsychotics and develop alternatives, yet progress has been frustratingly slow.
â€œWhile we welcome research that can inform doctorsâ€™ decisions about prescribing existing medication, we urgently need to find safer, more effective treatments for people with dementia. These can only come through research, but funding for dementia research still lags far behind that of other serious diseases. If we are to improve the lives of people with dementia, we must invest in research.â€
This material has been published with the kind permission of Alzheimer Research UK.
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