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Antipsychotics Overprescribed to Seniors with Dementia in Home Health Care, Despite Serious Risks, Study Indicates

Researchers found that elderly people with dementia receiving home health care who took antipsychotic drugs had less improvement in performing activities of daily living than those who had not taken the drugs.


The U.S. Food and Drug Administration requires antipsychotic drugs to carry a warning that says elderly patients with dementia treated with antipsychotics have an increased risk of death.

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Antipsychotic use by elderly with dementia was also linked to worse outcomes in performing their activities of daily living after home health care ended.

[Antipsychotics] now bear a boxed warning noting the risks of using them to treat elderly patients with dementia.”

— U.S. Food and Drug Administration

WASHINGTON, DC, US, October 5, 2023 /EINPresswire.com/ — A new clinical study has found evidence that powerful antipsychotic drugs are overly prescribed to older persons with dementia who receive home health care, despite the serious risk to the elderly of pneumonia, stroke, and heart failure from the drugs. The study also linked antipsychotic use by seniors with dementia to worse outcomes in the performance of their activities of daily living after home health care ended, as compared to those who had not taken the drugs.

Researchers from the University of Rochester Medical Center in New York reviewed the medical records of 6,684 adults aged 65 and older who received home health care and found that those with Alzheimer’s or other dementias were more than twice as likely to be prescribed antipsychotics (17%) as those without dementia (7%). Seniors with behavioral problems associated with their dementia were more than five times as likely to be given antipsychotic drugs, apparently an off-label use of the drugs to sedate patients with agitation or aggression from their dementia.

The U.S. Food and Drug Administration (FDA) has warned about this use of antipsychotic drugs in the elderly because of the increased risk of death. “Controlled trials have revealed increased mortality resulting from this use, primarily resulting from deaths due to cardiovascular events and infectious disease,” the FDA says. “These products [antipsychotics] now bear a boxed warning noting the risks of using them to treat elderly patients with dementia.” A boxed warning is the FDA’s most serious type of warning.

The new study also found that after the home health care ended, elderly patients with dementia who had taken antipsychotics had less improvement in their functioning in activities of daily living than those who had not taken the drugs.

“[Home health care] patients living with [Alzheimer’s disease and related dementias] were more likely to use antipsychotics and to experience worse functional outcomes when using antipsychotics,” wrote lead author JinJiao Wang, PhD, RN, at the Elaine Hubbard Center for Nursing Research on Aging at the University of Rochester in Rochester, New York.

Wang and colleagues recommended increased efforts to improve patients’ access to, and caregivers’ awareness of, non-drug approaches for managing behavioral problems from dementia. The study was published in the Journal of the American Geriatrics Society.

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an investigation into whether elderly residents of nursing homes are being falsely reported as having schizophrenia so they can be inappropriately sedated with antipsychotic drugs.

A report last year by the U.S. Department of Health and Human Services (HHS) Office of the Inspector General disclosed that from 2015 through 2019, the number of nursing home residents reported as having schizophrenia nearly tripled (194%). [1]

“No nursing home resident should be improperly diagnosed with schizophrenia or given an inappropriate antipsychotic,” said HHS Secretary Xavier Becerra earlier this year. [2]

The new scrutiny by CMS into the prescribing of antipsychotics to the elderly is a welcome step towards ensuring quality care in a safe environment for this vulnerable population.

WARNING: Anyone wishing to discontinue or change the dose of an antipsychotic or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from psychiatric drugs, as well as the research questioning the effectiveness of the drugs, so consumers and their physicians can make fully informed decisions about starting or stopping the drugs.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining hundreds of laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured major cities worldwide and educated people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

[1] https://oig.hhs.gov/oei/reports/OEI-07-20-00500.pdf
[2] https://www.cms.gov/newsroom/press-releases/biden-harris-administration-takes-additional-steps-strengthen-nursing-home-safety-and-transparency

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office
+1 202-349-9267
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CCHR: Psychiatric Abuse of the Elderly

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