Antipsychotics increase stroke risks
in dementia patients

medication being offered

Sometimes antipsychotics are needeed to curb troublesome behoviours

Antipsychotics are sometimes given to elderly patients suffering from Alzheimer’s disease and other forms of dementia to curb anxiety, psychosis, agitation, insomnia and aggression. Sadly, in many cases, they are administered more or less routinely, since it is seen as an easy option in keeping otherwise troublesome patients calm and quiet.

The need for something to make life a little more bearable for these patients (and the staff who care for them) is understandable; dementia patients can sometimes become uncharacteristically aggressive due to anxiety and agitation, and this is never a good thing, either for the patient, or the carers. Needless to say, it’s also distressing for the patients’ families.

Antipsychotics can increase stroke risks

Dementia patient

Dementia patients are at heightened risk of strokes if put on antipsychotics

The Alzheimer’s Society claim that the use of these drugs could triple the risk of potentially fatal strokes, and double the risk of death. Research indicates that at least 1,800 dementia sufferers die each year from the ‘chemical cosh’ drugs, and that only twenty percent of the 180,000 dementia patients who are prescribed antipsychotics actually benefit from them. This would seem to indicate that as many as 150,000 were prescribed them unnecessarily, and were therefore put at increased risk of strokes needlessly.

Writing in the journal Biological Psychiatry, researchers at the National Taiwan University claim that patients who received high doses, or were on the treatment for only a short time, were at higher risk. They believe their research shows that the risk is highest in the first few weeks of the drug treatment.

The researchers recommended that doctors start patients on antipsychotics at a low dosage and keep them under close observation for the first few weeks.

Patients with Alzheimer’s at risk from ‘chemical cosh’

A spokesman for the Alzheimer’s Society said,

“Tens of thousands of people with dementia are having their lives put at risk every day by being inappropriately prescribed this ‘chemical cosh’ which can double the risk of death, treble the risk of stroke and can leave people unable to walk or talk.
‘Whatever the situation, antipsychotics should only ever be used as a last resort. They should be prescribed at low dosages
and should be closely monitored.
‘Only by empowering staff with the knowledge they need to understand dementia and the person behind the condition can we ensure that the inappropriate prescribing of these harmful drugs is stamped out for good.”

And Dr Clare Walton, Research Communication Officer from the Stroke Association, said:

“This research shows doctors need to be cautious about the dose and type of antipsychotics they prescribe, especially for older people or anyone at risk of stroke.

‘If antipsychotics are being used, we recommend patients are closely monitored for the first few weeks when stroke risk seems to be highest.”

We need to monitor the use of antipsyschotics

Dr Simon Ridley, Head of Research at Alzheimer’s Research UK, pointed out that this study provided even more evidence that highlights the potential risks in prescribing antipsychotics for dementia patients. He also stressed that it is vital to monitor the use of such drugs, particularly in the initial stages.

Coping with the very challenging behaviour of some patients is never an easy task, and the staff entrusted with that work are very often some of the most compassionate and caring of individuals.

I can personally attest to this, having had a relative with dementia who spent some years in a care home. I could not fault their professionalism, nor their endless patience and truly caring attitude, attributes which make an almost unendurable situation less of a nightmare, both for the patient and their relatives.

And, in my experience, the doctors and staff were well aware of the need for the greatest of care in prescribing and administering calming drugs.

Many care homes are excellent, but some …

Still, in care homes generally, this is sadly not always the case. Let’s hope that those in positions of authority in these establishments take note of what the researchers have found, and take on board the need for caution in the use of potentially dangerous drugs in the treatment of aggression, anxiety, and other worrying symptoms.


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