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Nearly three-quarters of older American adults with dementia have filled prescriptions for drugs that are not designed for brain disease, according to a new study.
The researchers found that many had filled at least one prescription for antidepressants, opioid pain relievers, epilepsy medications, anxiety medications, or antipsychotics.
In addition, patients who were female, Caucasian, and in their 60s or 60s were the most likely to do so.
The team, at the University of Michigan at Ann Arbor, say these psychoactive drugs could lead to dangerous side effects such as nausea, nervousness or agitation, which could lead to an even larger prescription.
A new study found that of more than 737,000 patients with dementia, 73.5% of them had filled at least one prescription for opioids, antipsychotics, antidepressants, anxiolytics and antiepileptics. one year course (image file)
For the study, published in JAMA, the team looked at the Medicare prescribing records of 737,839 people with dementia and an average of 82 years old.
The researchers then looked to see if they had filled prescriptions for several classes of psychoactive drugs, including opioids, antipsychotics, antidepressants, anxiolytics and antiepileptics.
None of these drug classes have received approval from the US Food and Drug Administration for use in patients with dementia.
In all, 73.5 percent of patients filled at least one prescription for one of the above drug classes within a year.
About half of the study participants had taken antidepressants, which could be prescribed in an attempt to counter the withdrawal and listlessness often seen in dementia, according to lead author Dr Donovan Maust, geriatric psychiatrist at the University of Michigan and VA Ann Arbor Healthcare System.
However, he says antidepressants don’t treat these symptoms of dementia.
“Apathy and withdrawal, as well as a tendency to restlessness, are common symptoms of dementia,” said Maust.
“And while healthcare providers want to help these patients and their caregivers, these drugs just aren’t helpful enough to warrant that amount of prescription.
The patients most likely to fill non-dementia prescriptions were women, whites, in their late 60s and early 70s, and in low income.
The second most common class of drugs in which at least prescription was filled were opioids, with around 30 percent doing so.
The researchers believed that opioids could be prescribed not only to treat pain, but also behavioral symptoms such as aggression and restlessness.
However, there are safety concerns – such as the risk of addiction – and a lack of evidence for the benefits of opioids.
About 27% filled prescriptions for anxiolytics, which inhibit anxiety, and about 22% each received antiepileptics and antipsychotics.
Maust says most of those who received opioids only filled one or two short-term prescriptions, which may indicate they had been injured and were treating the pain.
But for those who took the other classes of drugs, they often received multiple prescriptions, such as medicines for epilepsy, sometimes prescribed as substitutes for antipsychotics or to treat chronic pain.
“A brain with dementia does its best to function as well as it can,” said Maust.
“If we add a mind-altering drug to the mix it may not help – and it comes with risks.
The team says all drugs are linked to risks to older people such as falls or addiction, which could lead to withdrawal.
In addition, all medicines have side effects such as nausea or nervousness.
Maust says the person with dementia may not be able to communicate the side effects to their loved one, and may just appear agitated, which requires them to take another medication to calm them down.
“As a nation, our goal is to keep dementia patients in the community as much as possible. But the use of these drugs appears to be as high for them as it is for those in nursing homes, ”he said.
“Clinicians and caregivers may need more support to come up with non-drug approaches to prevent or treat symptoms for which these drugs are likely prescribed.
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