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Antipsychotic medication Use in Nursing Homes


Updated: December 12, 2005

News that yet another study shows widespread use of antipsychotic medicine in nursing homes does not come as a shock to most medical professionals. The drugs, designed to treat schizophrenia and major psychiatric illnesses, are used to change and control the behavior of people with Alzheimer’s disease and other dementias. The study has found that 24% of people who moved into a nursing home were put on antipsychotic drugs within a year. A worrying, but not particularly surprising statistic.

The research, carried out by the Institute for Clinical Evaluative Sciences in Toronto, examined the data of medical records from nearly 20,000 people over the age of 65 years who were resident between the years of 1998 and 2000 in a nursing home in Ontario. They found:

  • 24% of nursing home residents who moved to the nursing homes where put on antipsychotic medicine within a year of admission.

  • The geriatrician or psychiatrist only saw 14% of the residents before the drug was administered.

  • Nearly 10% of the residents received an initial dose that exceeded recommend dose levels.
  • The use of antipsychotic medicine in the treatment and control of people with Alzheimer’s disease and other forms of dementia is controversial. There are many other studies that express the concern of the use and over use of this type of medication, from Singapore to Britain, Sweden to USA.

    Antipsychotic Drugs Explained

    The desired effect of antipsychotic medication is to make a person feel tranquil, but it should not impair their level of consciousness and should not be regarded merely as tranquillizer. Certainly when used for people with schizophrenia the tranquilizing effect should be of secondary importance.

    Antipsychotic drugs are used to help a people with severe anxiety and they also plays a significant role in quietening disturbed people.

    Antipsychotic drugs do have a role in short term control of disturbed and aggressive behavior but people taking them need to be regularly assessed to maximize their efficiency. Such drugs should be used along with other therapies to relieve the more distressing symptoms of dementia.

    How Do They Work

    Antipsychotic drugs are believed to act by interfering or blocking dopamine receptors in the brain. The first of this type of drug, Thorazine, was developed in France and within a year some 2 million people where being prescribed it. Side effects are minimized with the ‘new generation’ drugs, so called, atypical antipsychotic drugs such as Olanzapine (Zyprexia) and rispiradone (Risperdal).

    Side Effects

    So-called extrapyramidal side effects are one of the more problematic and serious side effects and are more common in the elderly. The Parkinson-like state include tremors, abnormal face and body movements and can occur after only a few doses. Although the atypical type of antipsychotic drugs do minimize the worst side effects, in some cases the side effects become permanent, a state known as tardive dyskinesia.

    Other side effects include low blood pressure, interference with body temperature (hypothermia in the elderly), cardiac and blood disorders, to name but a few.

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