Nearly one in seven elderly nursing home residents, nearly all of them with dementia, are given powerful atypical antipsychotic drugs even though the medicines increase the risks of death and are not approved for such treatments, a government audit found. More than half of the antipsychotics paid for by the federal Medicare program in the first half of 2007 were “erroneous,” the audit found, costing the program $116 million for those six months. “Government, taxpayers, nursing home residents as well as their families and caregivers should be outraged and seek solutions,” Daniel R. Levinson, inspector general of the Department of Health and Human Services, wrote in announcing the audit results.
Conventional antipsychotics, antidepressants and benzodiazepines often administered to nursing home residents are no safer than atypical antipsychotics and may carry increased risks, according to an article in CMAJ (Canadian Medical Association Journal).
Psychotropic medications are often used to manage behavioral symptoms in seniors, particularly people with dementing illnesses, with up to two-thirds of dementia patients in nursing homes prescribed these medications. However, the effectiveness of these drugs in this indication is unclear and important safety concerns exist, especially related to antipsychotics.
Nearly 25 percent of the residents in California’s nursing homes are placed on antipsychotic drugs, often used as sort of a chemical leash to control behavior in a trend a watchdog called an epidemic Thursday at a symposium. The drugs can double the risk of death for seniors with dementia and cause side effects ranging from stroke to delirium, according to speakers at an Oxnard conference called “Toxic Medicine.”
Pharmaceutical companies view the elderly as a lucrative market. However a panel of experts at the recent Senate Aging Committee forum decided to speak up. Over-medication occurs far too often in those diagnosed with dementia, the panel warned, and as baby boomers age the problem will only worsen. One reason overmedication occurs, per this panel, is family members, caregivers, and nursing home workers often misinterpret patients’ complaints about physical ailments as unruly or aggressive conduct. To manage their behavior, such patients are administered antipsychotics they don’t need.
About five million patients are currently diagnosed with Alzheimer’s and other forms of dementia. “Those in this field have a feeling we’re headed in a very fast train toward the end of a cliff,” stated Patricia Grady, PhD, director of the National Institute of Nursing Research. Director of California Advocates for Nursing Home Reform, Patricia McGinnis, demanded nursing homes be held “accountable” for the drugs they administer. “The way anti-psychotic drugs are used in nursing homes is a form of elder abuse,” she told the forum. “Instead of providing individualized care, many homes indiscriminately use these drugs to sedate and subdue residents.”
A federal judge has refused to toss out a whistleblower lawsuit backed by the Department of Justice (DOJ), which accuses Johnson & Johnson of involvement in an illegal kickback scheme to push their antipsychotic drugs on elderly nursing home residents that did not need them. The DOJ filed a civil False Claims Act compliant against J&J on January 15, 2010, saying that the company paid millions to Omnicare, Inc. as kickbacks for selling Risperdal to nursing home patients.
According to a recent report from the United Kingdom, side effects of Risperdal and other similar antipsychotics, like Seroquel, Zyprexa and Abilify, could be linked to as many as 1,800 deaths and 1,620 strokes per year in elderly patients with dementia.