The debate over drug use in dementia patients continues apace. A New York Times article today trots out the stats--about one-third of nursing home patients have been prescribed antipsychotics, for instance--and reviews the evidence that antipsychotics new and old are overused in patients with dementia. Experts told the paper that they should be used as a last resort to calm patients who are self-destructive or violent.
As you know, several states are suing makers of atypical antipsychotics, alleging false and misleading marketing. The U.K. is reviewing use of the meds in dementia patients. And the FDA recently added a warning of the increased risk of death among dementia patients who use old-style antipsychotics; the atypicals have carried such a warning since 2005.
While antipsychotics might be overused, there's a class of drugs that may not be used enough: antidementia meds like Eisai's Aricept and Novartis' Exelon. Up to 20 percent of Alzheimer's patients noticeably improved on the drugs, and 40 percent more showed some cognitive improvement that wasn't as readily apparent. Plus, some nursing homes are trying nondrug treatments. Simply by paying more attention to residents, these facilities are getting results. The problem is, they're time-consuming--and thus expensive.
- read the NYT story