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Nurses appealed to question antipsychotic drug use for dementia

Nurses are being urged to question the use of antipsychotic drugs for people with dementia after a campaign claimed they result in illness, confusion and unnecessary death.

The Dementia Action Alliance, a coalition of charities and professional bodies including the Royal College of Nursing, estimates up to five dementia sufferers die every day as a result of taking antipsychotic medication they may not need.

Under the banner of the Right Prescription Campaign the alliance is calling for every one of the 180,000 dementia patients currently on antipsychotics to have their prescription reviewed by the end of March 2012.

Alzheimer’s Society head of policy Andrew Chidgey said nurses were “vitally important” if the ambitious target was to be achieved.

“Nurses are the people who are very involved in caring for people with dementia and are often in a position where they can see people being prescribed antipsychotic drugs and question whether it’s appropriate,” he said.

“People with dementia become aggressive and agitated in hospital and care homes. Nurses can play a really important role in making sure people are well supported in that environment so those symptoms don’t occur.”

Mr Chidgey said antipsychotics, such as Rispiradone, were often prescribed when patients suffered particularly severe symptoms. However, patients were then left on such drugs for “months and months”.

Research has shown antipsychotics to increase the risk of stroke and almost double the risk of early death when taken over a prolonged period.

Other side effects associated with the drugs include dehydration, chest infections, ankle oedema and deep vein thrombosis while they can also increase the symptoms of dementia and cause dizziness and unsteadiness which may lead to falls.

Mr Chidgey added: “They can have a sedative effect and cause mobility problems which leads to falls and fractures.

“People with dementia are already finding it very difficult to understand the world around them; having drugs that will increase their sense of confusion can make that even more difficult.

“Nurses can make sure patients have their prescriptions reviewed.”

The campaign has published a best practice guide for health professionals which is available online at www.alzheimers.org.uk/antipsychotics.

Readers' comments (8)

  • Perhaps another approach should be taken towards dementia care. As Mr Chidgey has said, using drugs doesn’t necessarily help the condition and can in fact worsen the patients situation. An original approach to dealing with dementia has been taken by Beatitudes nursing home in the United States. Disregarding typical nursing-home rules, Beatitudes approach to dementia is particularly unconventional but many would argue effective and so certainly better than the use of antipsychotics.

    To read more: http://tinyurl.com/6gxr9lf

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  • these drugs are not only used in patients with dementia but also other over active elderly patients in homes as there is inadequate staffing levels and skills to manage them otherwise.

    there are several highy successful models for the management of patients with dementia inlududing supervision and naomi pfeil but adequate staffing levels and specialist training and facilities fit for purpose are also required. I wonder if in the long run good care would not also be a more cost effective alternative than antipsychotics and certainly far more comfortable, creative, rewarding and agreeable for all concerned.

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  • meant to add kinder to the patient to the list in the last sentence above as well - and one could further more humane!

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  • From
    Anonymous | 14-Jun-2011 1:53 pm
    and
    µ | 14-Jun-2011 1:55 pm

    left the second 'add' out!
    should read " - and one could further add more humane!"

    when will NT add an editing facility to the comments so these errors can be rectified in the post itself?

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  • Nothing really changes, controlling patient behaviour with drugs to suit staffing levels and lack of training.

    Nurses having to question the appropriateness of antipsychotic prescribing (good job we do!)....who prescribes these drugs in the first place? Well, we all know who..

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  • I work as a Behaviour Consultant for Alzheimers Australia and my background is Mental Health Nursing (trained and worked in the Uk for many years). As a Behaviour Consultant I fully support psychosocial intervention in my approach with dementia care. In many cases, I am pleased to say that this has proved immensely successful and it clearly highlights there is an alternative and effective way to managing BPSD other than using medication such as antipsychotics as first line tretament.

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  • Christina Smith | 17-Jun-2011 3:24 pm

    yes, but doesn't this all boil down again to having staff in sufficient numbers and skill mix?

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  • consideration needs to be given to effects caused by drugs, including antipsychotics, on patients who are dehydrated and malnourished. in fact, the time spent in administering these drugs which patients may not need would be better spent on basic essential care such as ensuring patients are adequately fed and hydrated!

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