"Antipsychotic Drugs for Dementia To Be Curbed in U.K."


Nov. 12 (Bloomberg) -- British patients with dementia too often get dangerous antipsychotic drugs, causing as many as 1,800 deaths and 1,620 strokes a year, a report commissioned by the U.K. Department of Health found.
11月12日 (ブルームバーグ) -- 英保健省の委員会報告書によると、英国内の認知症患者は危険な抗精神病薬を過剰に投与されており、それによって年間1800人に上る患者の死亡、1620人が発作を起こしている

The government announced a plan today to curb overuse of the medicines, which include Eli Lilly & Co.’s Zyprexa, Johnson & Johnson’s Risperdal, Bristol-Myers Squibb Co.’s Abilify and AstraZeneca Plc’s Seroquel. The drugs, designed to treat schizophrenia, are often inappropriately used as a first-line therapy to quell behavioral problems in people with dementia, according to the report by Sube Banerjee, professor of mental health at King’s College London Institute of Psychiatry.

About 180,000 elderly people with dementia in the U.K. are given the antipsychotic drugs each year, and just 20 percent improve because of the treatment, Banerjee said at a press conference in London. As many as two-thirds of the patients don’t derive any benefit from the pills, which boost the risk of early death and carry a range of side effects including sedation, stiff muscles, and trouble thinking and speaking clearly, the report found.

“We need to be sure that only the people who benefit from these drugs get them, and they get them at the lowest possible dose for the shortest period of time,” Banerjee said. “It is clear that these medications are being prescribed to deal with behavior and psychological symptoms in dementia rather than just for psychosis,” he wrote in the report.

‘Behavioral Therapies’

All of the medications, including older, generic drugs such as Haldol and Thorazine, have the same effect, Banerjee said. As a result, doctors can’t switch patients from one medication to another to solve the problem. Instead, they need to focus on basic techniques, such as trying to determine the cause of a patient’s agitation, and behavioral therapies to improve the situation, he said. In some cases, simple problems such as lack of sleep or hunger can be the cause, he said.

“It is unacceptable that antipsychotic drugs are routinely prescribed to people with dementia,” said Health Minister Phil Hope. “I know we’re not going to reduce the use of these drugs overnight, but it can be done.”

The government accepted the recommendations from Banerjee and plans to hire a national clinical director for dementia to oversee efforts to improve care and reduce unnecessary drug use, Hope said at the press conference.

‘Chemical Restraints’

“The use of these chemical restraints really should be a last resort,” said Neil Hunt, chief executive officer of the Alzheimer’s Society. “We’ve got a culture and an ingrained pattern of care to shift here.”

In 2005, the U.S. Food and Drug Administration required makers of antipsychotics to include in dosage instructions a prominent warning surrounded by a black box about the increased risk of premature death in elderly patients with dementia. A U.K. study released two years later found patients getting the drugs die six months earlier than those who don’t receive them.

“It’s a shame the report arrives so heavily delayed when many people have died prematurely from taking these drugs,” Rebecca Wood, chief executive officer of the Alzheimer’s Research Trust, said in a statement. “This new plan has the potential to stem the flow of unnecessary deaths, an injustice that has affected too many families for too long, and needs to be implemented swiftly.”