Worse Than Meds for Kids?
The elderly in nursing homes have long been overmedicated, but because of societal prejudices and disregard, little attention has been paid by the mainstream media. Now, however, one of the most popular stories on the New York Times website is one about this very problem, but in specific, the issue of using antipsychotics.
Interestingly, when my grandmother was in her nursing home, the Fountains, she alleged she was being given sleeping pills or sedatives that weren’t explicitly prescribed for her. She was lucid and didn’t suffer from dementia, but it was hard to believe — that they were doping her up? These days it seems less fantastic.
From the Times:
The use of antipsychotic drugs to tamp down the agitation, combative behavior and outbursts of dementia patients has soared, especially in the elderly. Sales of newer antipsychotics like Risperdal, Seroquel and Zyprexa totaled $13.1 billion in 2007, up from $4 billion in 2000, according to IMS Health, a health care information company.
Part of this increase can be traced to prescriptions in nursing homes. Researchers estimate that about a third of all nursing home patients have been given antipsychotic drugs.
The increases continue despite a drumbeat of bad publicity. A 2006 study of Alzheimer’s patients found that for most patients, antipsychotics provided no significant improvement over placebos in treating aggression and delusions. …
The agency has not approved marketing of these drugs for older people with dementia, but they are commonly prescribed to these patients “off label.” Several states are suing the top sellers of antipsychotics on charges of false and misleading marketing.
Ah, the good old off-label prescribing. I wouldn’t be well if it weren’t for off-label, but it is, as they say, a slippery slope. And in this instance, and for children, I think it has to be used with great caution.
I know the elderly isn’t anyone’s target demographic. I know we value children more because they represent the future. But I refuse to consign anyone to the past. It’s never acceptable to be finished with another human being. I’m glad the Times is on this.
Doctors Say Medication Is Overused in Dementia
[Photo by Miguel A. Lopes "Migufu" via Flickr.]
liz | 10:00 AM | Uncategorized
I wonder if those who zealously advocate for the broad use of antipsychotics feel about the possibility that they too could be prescribed these drugs in future. Perhaps, an appreciation of this fact might render them less sanguine about their use and misuse.
I saw this article in the times and knew you would be all over it.
A few counter-points:
1. Complex subject, simplistic NYT article. Nursing homes in general are horribly understaffed (or staffed with poorly trained staff) and managing difficult behavior is a challenge.
2. Despite the fact that using antipsychotics for the agitation of dementia is “off label” such use follows American Association of Geriatric Psychiatry protocol.
3. The Fountains back in the day was a Taj Majal compared to most nursing homes today. Today’s nursing home patients are MUCH sicker-psychiatrically and medically- than they used to be. Sicker patients means worse symptoms(as in “Mr Jones just threw a chair at his roomate”).
P.S. Your article on the Lavins was great. If you look the word gonif up in the dictionary there is a picture of a Lavin family seder.
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