Concern growing: Doping of the Elderly

Wednesday, 30 April 2008

Concern is growing about the doping of elderly rest home residents with anti-psychotic drugs.

British research shows the practice - soon to be the subject of a New Zealand study - can result in premature death.

Researchers from King's College in Britain compared the life expectancy of people with dementia and prescribed anti-psychotic medication with those not on the drugs.

They found those given anti-psychotic drugs, not designed to treat dementia but sometimes used to control aggression, died much earlier.

After 24 months on the study, more than 45 per cent of those taking anti-psychotic medication had died compared with 22% of people in the other group.

It is unknown exactly how many elderly New Zealanders with dementia or Alzheimer's disease are prescribed the psychiatric medications.

However, a group of North Island researchers will soon publish a study looking at the use of anti-psychotic medication in rest homes.

Old-age psychiatrist Matthew Croucher said far too many elderly were likely to be prescribed anti-psychotic drugs unnecessarily.

The drugs made them more likely to fall over and hurt themselves, have a stroke and in some cases die prematurely, while the benefits were modest, he said.

"Overseas there is an increasing concern about the use of anti-psychotics among the elderly. In the UK inappropriate over-medication is widespread," he said. "Here we are now looking at the issue because it is a significant one."

Croucher is one of a team of people recently charged by New Zealand's drug agency, Pharmac, to write prescription guidelines for anti-psychotic use in rest homes. He was also reviewing the North Island research.

Age Concern Canterbury chief executive Andrew Dickerson said he was disturbed by the British study, which was done by credible university academics.

He considered it abuse for people to be inappropriately medicated in rest homes, particularly if it happened because of staff shortages.

People with dementia could sometimes be difficult and required high levels of care but over-sedating them was not an appropriate response, he said.

Alzheimers New Zealand national director Lucille Ogston said it was sometimes appropriate to use anti-psychotic drugs to control intense physical or behavioural issues in people with dementia or Alzheimer's disease.

However, this was generally appropriate only in small doses and over short periods of time.

Staff shortages in rest homes and a lack of properly trained carers meant doctors were sometimes put under pressure to prescribe anti-psychotic drugs to control or sedate elderly, Ogston said.

She and Dickerson welcomed Pharmac's decision to write guidelines on the use of anti-psychotic drugs as a first step to understanding the scale of the problem in New Zealand.