Use of antipsychotic drugs among dementia patients increasing, study suggests

Academics at the University of Exeter and King’s College London compared current prescribing with pre-coronavirus levels.

04 August 2022

Prescribing potentially harmful antipsychotic drugs to people with dementia has increased by more than 50% on average in care homes during the pandemic, new research suggests.

Academics at the University of Exeter and King’s College London compared current prescribing with pre-coronavirus levels.

They said the number of people with dementia receiving these prescriptions had soared from 18% to 28% since 2018 – with prescription rates of over 50% in a third of care homes.

The research data compared more than 700 care home residents taking part in two studies either side of the pandemic.

Professor Clive Ballard, who was part of a national campaign in 2009 to reduce antipsychotic prescribing by half, said: “Covid-19 put tremendous pressure on care homes, and the majority of them must be applauded for maintaining relatively low antipsychotic prescribing levels amid incredibly difficult circumstances.

“However, there were very significant rises in antipsychotic prescribing in one third of care homes and we urgently need to find ways to prioritise support to prevent people with dementia being exposed to significant harms.”

Antipsychotic drugs are used to treat some of the more distressing behavioural and psychological symptoms of dementia, such as agitation and psychotic episodes.

They have only very limited, short-term benefits in treating psychiatric symptoms in people with dementia – but significantly increase the risk of serious side effects, including stroke, accelerated decline and death.

Covid-19 presented unprecedented challenges for care homes, where around 70% of residents have dementia.

Some of the challenges facing care homes included access to PPE, staffing levels, isolation, and caring for residents in lockdown conditions.

Dr Richard Oakley, from the Alzheimer’s Society, added: “This study shows the shocking and dangerous scale of the use of antipsychotic drugs to treat people with dementia in care homes.

“Alzheimer’s Society has been campaigning for a move away from the model of ‘medicate first’ and funded research into alternatives to antipsychotic prescriptions, focused on putting people living with dementia at the centre of their own care.

“This drug-free, tailored care can help avoid the loss of lives associated with the harmful side effects of antipsychotic medications.”

An NHS spokesman said: “The NHS has significantly reduced the number of prescriptions for antipsychotic drugs since 2010 with guidance issued to GPs, pharmacists and other healthcare professionals on how to provide care that meets the specific needs of each patient.

“Expert pharmacy teams have also been rolled out across the country to give advice to patients and maximise other treatment options, where appropriate.”

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