antipsychotics

Wrong drugs used in dementia, experts say

Tracy Staton — Tue, 24 Jun 2008 07:49:13 -0400

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

U.K. scrutinizes antipsychotic use

Tracy Staton — Fri, 20 Jun 2008 10:17:45 -0400

Add to a host of U.S. probes a new U.K. look at the use of antipsychotic drugs in dementia patients. British ministers have ordered a review of the meds, which have been linked to an increased risk of death in elderly patients with dementia, but continue to be used to pacify aggressive and disturbed patients. It's part of a new effort in the U.K. to codify dementia treatment, in anticipation of a huge increase in cases as the population ages.

- read the BBC report
- check out the story in The Guardian

Enbrel, antipsychotics draw warning fire

Tracy Staton — Tue, 17 Jun 2008 11:04:57 -0400

Warning! Warning! Two new safety stories from the FDA hit the press yesterday: One on Amgen's rheumatoid arthritis and psoriasis drug Enbrel, and one on older antipsychotic meds such as Haldol and Thorazine.

First, the agency wants to beef up labeling for Enbrel to include a warning that, when used in children, the drug carries the risk of death. Enbrel is up for pediatric approval for use in psoriasis--currently it's only approved for psoriasis use in adults -- and in preparation for the advisory committee discussion tomorrow, FDA staffers combed the adverse events database. They found some serious problems in kids using Enbrel, such as malignancies, infections, and neurological problems, many of them life-threatening--and some deadly. Given the fact that the number of children on Enbrel is fairly small, these serious adverse events are a red flag, FDA said. The agency is recommending that the label be changed, regardless of whether the drug gets the additional psoriasis nod.

Meanwhile, the FDA warned doctors that dementia patients using older antipsychotics appear to be at an increased risk of dying. A "black box" warning is going on the meds, which are sometimes used off-label to calm aggressive or out-of-control dementia patients. It's similar to the cautionary tale on newer antipsychotics, a.k.a. atypicals, which got a death-risk black box for dementia use three years ago.

- see the Wall Street Journal article
- check out the Washington Post story

U.K. kids' antipsychotic use doubled

Tue, 06 May 2008 06:59:55 -0400

The number of U.K. kids taking antipsychotics has doubled in recent years, expert say, as use of the meds has broadened to hyperactive and autistic children. The increase was most marked among 7- to 12-year-olds, where the rate almost tripled from two per 10,000 children to 6 per 10,000 between 1992 to 2005. This in spite of the fact that most of the drugs aren't approved for use in kids, according to a new study in The Lancet.

What's more, American kids take antipsychotics at six times the rate of U.K. kids--45 of 10,000 used them in 2001 compared with 23 per 10,000 in 1996, according to a 2004 study. One of the authors of that research said that U.K. docs tend to be more conservative in prescribing psychiatric meds.

Side effects reported in children include weight gain, heart trouble, and nervous-system problems, the authors of the Lancet study said. "This highlights the need for long-term safety investigations and ongoing clinical monitoring," they said, "particularly if the prescribing rate of these medicines continues to rise."

- read the Associated Press story
- see the article in The Telegraph

ALSO: AstraZeneca presented data on its antipsychotic Seroquel XR to the American Psychiatric Association, saying that the med outperformed placebo in treating major depression and generalized anxiety disorder. In February AstraZeneca asked the FDA for a depression indication for the med and plans to submit an anxiety application this quarter. Report