Deadly risk of antipsychotic drugs for Alzheimer's patients
Alzheimer's patients twice as likely to die if receiving long-term course of antipsychotic drugs
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Friday, 09, Jan 2009 03:01
Alzheimer's patients are twice as likely to die if receiving a prescription of antipsychotic drugs, research has shown.
Antipsychotics are used to treat symptoms of agitation, delusions and aggressive behaviour in dementia sufferers.
But a UK study has shown a "significant increase in risk of death" for patients who receive a long-term course of antipsychotics.
Funded by the Alzheimer's Research Trust, research from King's College London saw 165 patients divided into two groups, one continuing to receive antipsychotic drugs and the other being given oral placebos instead.
The difference between the two groups became more pronounced over time, with 24-month survival rates for antipsychotic-treated patients falling to 46 per cent versus 71 per cent on the placebo and at 36 months it was 30 per cent versus 59 per cent.
After three years, less than a third of people on antipsychotics were alive compared to nearly two thirds using the dummy drug.
Official guidelines recommend that the drugs should only be used for short periods of time and where symptoms are severe, and should be very carefully monitored, although in clinical practice the average length of prescription is between one and two years.
While there is evidence of modest short-term benefits of antipsychotic treatment for the serious behavioural symptoms of Alzheimer's, a previous Alzheimer's Research Trust study showed that these benefits were not evident over longer periods of treatment.
As many as 100,000 people with dementia are routinely prescribed antipsychotics in UK care homes. It could mean 23,500 people dying prematurely, according to a 2008 report by Paul Burstow MP.
Professor Clive Ballard, who led the research, said: "The results further highlight the need to seek less harmful alternatives for the long-term treatment of behavioural 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 emphasise the urgent need to put an end to unnecessary and prolonged prescribing".
Alzheimer's Research Trust chief executive Rebecca Wood commented: "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.
"700,000 people in the UK have dementia; we urgently need to fund more research to develop the new treatments we so desperately need."
One in three people over 65 die with dementia, while by 2051 up to 1.7 million are expected to suffer from the neurodegenerative disease.