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Antipsychotics For Dementia Linked To More Harms Than Previously Acknowledged

A large, UK-based study published in the BMJ has suggested that antipsychotic drugs carry greater risks of serious health conditions than previously thought.

These drugs are sometimes prescribed to manage severe dementia symptoms, including agitation, hallucinations, and delusions. However, previous evidence of harms has led to efforts to restrict their use.

Despite these warnings, their use increased during the COVID-19 pandemic.

The new research is a collaboration between the Universities of Manchester, Nottingham, Edinburgh, and Dundee. Researchers examined health records of over 150,000 people in England over 50 years old with a dementia diagnosis.

Prof Darren Ashcroft, the study’s senior author, from the University of Manchester, said: “In recent years, it has become clear that more people with dementia are being prescribed antipsychotic drugs, despite existing regulatory safety warnings.

“It is important that any potential benefits of antipsychotic treatment are weighed carefully against the risk of serious harm, and treatment plans need to be regularly reviewed in all health and care settings.”

Commenting on the findings, Dr Sheona Scales, Director of Research at Alzheimer’s Research UK, said the study reinforced existing evidence. “These concerns have been known for some time. Alzheimer’s Research UK-funded researchers revealed dangers of antipsychotics in 2008, which raised concerns about their use and prompted government intervention to reduce their prescription.”

The harms previously associated with antipsychotics include an increased risk of conditions such as pneumonia and stroke when given to people with dementia. But there has been less evidence around other conditions, such as heart failure and kidney injury.

The study found that over a ten-year period, people with dementia who had been newly prescribed an antipsychotic drug were more likely to have stroke, blood clots, heart attack, heart failure, fracture, pneumonia, and kidney injury compared to people who were never prescribed antipsychotics.

However, these harms need to be balanced against the fact that severe dementia symptoms such agitation and confusion can pose significant challenges for people living with dementia and those that care for them.

“Treatments that can help manage these symptoms are essential for a better quality of life, but options are currently limited, and in certain circumstances antipsychotics can be used to treat severe symptoms,” said Scales.

“These new findings suggest that these risks may be more severe than previously understood, which is particularly concerning given the rise in their use during the pandemic.”

“With nearly one million people affected by dementia in the UK, there is an urgent need for research to develop safer and more effective treatments. This means medicines that can alleviate these symptoms, and also address the underlying disease processes that cause dementia. There’s been welcome progress recently, but so much work remains to be done.