An elderly person with dementia, sitting in a dimly lit room, surrounded by medication bottles, highlighting confusion and isolation. Soft light focuses on the face, showcasing worry and vulnerability. Background shows faded medical charts illustrating declining health.
The growing concern surrounding the use of antipsychotics in dementia treatment has led to comprehensive research examining associated risks. This population-based study sheds light on the heightened danger patients face when treated with these medications, particularly the increased likelihood of life-threatening conditions such as pneumonia, stroke, and acute kidney injury.
The research team analyzed data from 173,910 adults diagnosed with dementia between 1998 and 2018. The results showed that, in comparison to non-users, individuals prescribed antipsychotics had significantly elevated risks for multiple adverse outcomes. Pearl L. H. Mok, one of the lead researchers, emphasized, “We found that the risks were much broader than initially reported. Particularly, the increase in pneumonia and stroke is alarming and calls for a reassessment of how antipsychotics are used.”
The team also pointed out that risks were particularly high within the first 90 days of drug use. Dr. Matthew Carr noted, “What struck us most was the immediacy of the danger. In the first three months, patients were more vulnerable to severe outcomes, including heart failure and venous thromboembolism.”
In contrast to previous regulatory warnings that focused primarily on the risk of stroke and death, this study uncovered a wider range of complications. Bruce Guthrie stated, “Our study adds to the growing body of evidence that the safety of these drugs needs reevaluation, especially for vulnerable populations like those with dementia.”
Despite the well-documented concerns, the use of antipsychotics surged during the COVID-19 pandemic. The increased isolation and reduced access to non-pharmaceutical interventions likely exacerbated behavioral symptoms in dementia patients, leading to a rise in prescriptions. Rachel Elliott commented, “The pandemic played a pivotal role in highlighting the over-reliance on these medications, which may have led to unnecessary harm.”
These findings underline the critical need for alternative treatment methods and stricter guidelines in prescribing antipsychotics to dementia patients. Dr. Daniel Morales emphasized, “Healthcare providers must weigh the benefits against the risks, especially given the higher incidence of pneumonia and kidney injury we’ve observed.”
This study is a wake-up call for both the medical community and caregivers. With the aging population expected to rise sharply by 2050, the impact of such treatments on dementia patients needs to be carefully considered. Further research is required to explore safer alternatives and refine treatment protocols for those most vulnerable.
Citation:
Mok PLH, Carr MJ, Guthrie B, Morales DR, Sheikh A, Elliott RA, Camacho EM, van Staa T, Avery AJ, Ashcroft DM. Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study. BMJ. 2024;385. doi:10.1136/bmj-2023-076268.
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