Dementia patients being ‘over-prescribed drugs’

ELDERLY patients with dementia in long term care are being over-prescribed antipsychotic drugs to compensate for a lack of resources, according to an expert in elderly care.

Dr Shaun O’Keeffe, a consultant in geriatric and general medicine at Merlin Park University Hospital Galway, said over-use of physical restraints is also a problem in many long-stay care homes.

Dr O’Keefe was giving a presentation called Learning the Lessons of Leas Cross at the AGM of the Irish Medical Organisation (IMPO) in Killarney, Co Kerry.

In an as yet unpublished survey of 345 public and private long-stay patients in the west of Ireland, Dr O’Keeffe found 23% of patients were taking regular antipsychotics: of that figure, more than half were taking antipsychotics inappropriately.

“The safety concerns with antipsychotics are a known risk of falls, sedation and parkinsonism,” Dr O’Keeffe said. In addition, there is a two to threefold increase in the risk of stroke in patients with dementia using respiridone or olanzapine and a threefold increased risk of cardiac death, Dr O’Keeffe said.

He said: “I am not trying to apportion blame, I know very well why it happens [under resourcing] and the pressures can be enormous to use medication in cases, but so are the hazards.”

A study funded by the British-based Alzheimer’s Research Trust found that, on average, patients with Alzheimer’s who are treated with anti-psychotic drugs die six months earlier.