Antipsychotics associated with much wider harms in dementia patients than thought

Use of antipsychotic medications in patients with dementia is linked with a much wider range of serious harms than previously thought, say UK researchers.

Although there have been safety warnings on use of the antipsychotics from regulators about increased risk of stroke and death, a large study has now found increased risks for pneumonia, venous thromboembolism, heart attack, heart failure, fracture, and acute kidney injury.

Reporting the findings in the BMJ, researchers from the University of Manchester said it underscores the need for increased caution when prescribing. The analysis showed that antipsychotic use was associated with increased risks for all outcomes looked at with the exception of ventricular arrhythmia. Over the first six months of treatment, it was estimated that antipsychotic use was linked with one additional case of pneumonia for every nine patients treated, and one additional heart attack for every 167 patients treated.

Professor Charles Marshall, professor of clinical neurology at Queen Mary University of London, said the study findings should prompt renewed efforts to reduce the prescribing of antipsychotics to people living with dementia. "There are rare circumstances where antipsychotics are genuinely required, and the benefits outweigh these risks, but for the majority of patients with behavioural symptoms that might lead to them being prescribed anti-psychotics, we should be focussing on much safer behavioural management approaches."

Read full story

Source: Pulse, 24 April 2024