Is It Safe to Give Older People Antipsychotics?

The recent practice of administering antipsychotic medications to the elderly is alarming. In fact, antipsychotic medications are prescribed to one quarter of Medicare beneficiaries in nursing homes. Only one quarter of elderly patients taking antipsychotics actually have a psychotic disorder, despite the fact that antipsychotics should not be used to treat dementia in the absence of a psychotic disorder. To put it another way, most prescriptions for antipsychotics are not appropriate for elderly patients who do not have an indication for the medication, such as hallucinations or delusions. Additionally, older patients taking these potent medications are more likely to experience adverse effects like elevated lipid levels and diabetes. The FDA recently issued a warning that the elderly are twice as likely to die from taking atypical antipsychotic medications.Can you stop taking Abilify?

Aggression, hallucinations, delusions, disorganized thoughts, and bizarre behavior are all possible signs of Alzheimer's disease. Antipsychotic drugs may be used to treat these symptoms. Antipsychotic meds ought to just be utilized in Alzheimer's patients who are crazy. That doesn't stop people from using them to try to calm down Alzheimer's patients or other elderly people with dementia or control them in other ways.

The brain's dopamine-2 receptor, thought to be involved in psychotic symptoms, is blocked by common antipsychotic medications. More importantly, antipsychotics—formerly known as "major tranquilizers"—are very sedative, which is why they are used to treat agitated Alzheimer's patients.

In fact, antipsychotic medications developed for schizophrenia are utilized just as frequently or more frequently in elderly dementia patients. All of the studies on the use of antipsychotics to treat behavioral issues in mentally ill patients were examined in one study. They discovered data on 1757 patients who were given a placebo and 3353 who were given an antipsychotic. Antipsychotic patients had an absolute increase in death of 1.2%. The authors came to the conclusion that antipsychotic treatment of mentally ill patients may increase the risk of death.

Thorazine, haloperidol, mellaril, and trilafon were among the first antipsychotics. However, these medications were linked to troubling extra-pyramidal side effects like lip smacking, twitching, and jerking. Additionally, they may impair memory in the elderly and have anticholinergic side effects.

A number of different dopamine receptors, in addition to other receptors like the serotonin receptors, are blocked by the second generation of atypical antipsychotic medications. It is believed that this is the explanation they are not related with extra pyramidal secondary effects. Clozaril, the first atypical, is occasionally linked to a fatal condition called agranulocytosis, in which the body stops making blood and immune cells. As a result, clozaril patients must frequently have their blood tested, which is very inconvenient. Zyprexa (olanzepine), Risperdol (risperidal), and Seroquel (quetiapine) are additional atypicals. There are fewer adverse effects on the brain with these medications. However, these medications have not been without their own set of issues. According to Newcomer (2004), they can disrupt glucose metabolism, increasing the risk of adult-onset (Type 2) diabetes and occasionally ketoacidosis. Additionally, they cause weight gain and raise lipid levels. Patients taking atypical antipsychotics may be more likely to develop heart disease as a result of all of these factors. Olanzepine (Sernyak et al. 2002) and clozepine (Sernyak et al. 2002) have been linked to an increased risk of diabetes, whereas risperidone (Sernyak et al. 2002) and standard antipsychotics have a lower risk. Quetiapine yields contradictory results (Sernyak et al., 2002).

When compared to the risk of death associated with atypical antipsychotics, the risk of death associated with typical antipsychotics was even higher. In dementia patients, there was a twofold increase in stroke risk linked to risperidone and quetiapine. In addition, quetiapine was linked to a more rapid cognitive decline over time than placebo, and neither rivastigmine nor quetiapine were effective treatments for agitation in elderly demented patients. As previously stated, elderly people should not be controlled by antipsychotic medications unless they are truly experiencing psychosis (e.g., seeing or hearing things that aren't there). They have not been shown to be helpful, and they make it more likely that someone will die.

The Canadian Drug Regulatory Authorities sent a letter to doctors about the increased risk of stroke in elderly patients with dementia taking olanzapine. However, the FDA did not send a similar letter to doctors in the United States. A lot of doctors in the United States are unaware of the risks and the advice not to use atypical antipsychotics for demented elderly patients with behavioral symptoms. Antipsychotic medications should not be given to Alzheimer's or other forms of dementia patients unless they clearly exhibit psychosis and meet the criteria for psychosis, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (such as seeing or hearing things that are not there, having frank delusions, or having incorrect beliefs).