- Elderly are twice as likely to be given the drugs, despite risk of death
- They may be used to control agitation to make life easier for care workers
- In 2004 doctors were told not to use anti-psychotics except as a last resort
More than half of prescriptions for anti-psychotic drugs in Britain are for conditions other than serious mental illnesses, say researchers.
And the elderly are twice as likely to be prescribed the drugs as people in their 40s, even though they are linked to a higher risk of premature death in older people.
The drugs, often dubbed the ‘chemical cosh’ because they are wrongly used to sedate dementia patients, are licensed for serious mental illnesses such as schizophrenia and bipolar disorder.
Dignity for the elderly: The elderly are twice as likely to be prescribed anti-psychotic drugs as people in their 40s, even though they are linked to a higher risk of premature death in older people. File picture
But a study of GPs’ prescriptions between 2007 and 2011, using an electronic database of anonymous patient records, found that less than half were prescribed the drugs for these conditions.
Often they were handed out for anxiety, sleep problems and personality disorders, as well as dementia, even though doctors have been told to prescribe them only as a last resort.
This ‘off label’ or unlicensed prescribing resulted in older people with conditions such as dementia and anxiety getting them, says the study published online by the journal BMJ Open.
Study author Professor David Osborn, of University College London, said antipsychotics are not recommended for dementia because they can increase the risk of stroke and death in older age groups.
Although not licensed for dementia, they may be used to control agitation and aggressive behaviour, making life easier for carers and nursing home staff.
The Alzheimer’s Society charity says antipsychotics should be prescribed for a minority of people with dementia and only for up to twelve weeks.
A Government-commissioned review found 180,000 people with dementia were prescribed antipsychotics, of which 144,000 were given them inappropriately.
Care scandal: A review found 180,000 people with dementia were prescribed antipsychotics, of which 144,000 were given them inappropriately
The Daily Mail has long called for an improvement in the care of dementia sufferers as part of our Dignity for the Elderly Campaign.
The researchers analysed GPs’ prescribing patterns for first and second generation antipsychotic drugs across the UK between 2007 and 2011, using data from The Health Improvement Network (THIN), a medical research database of anonymised electronic patient records.
Between 2007 and 2011, almost 48,000 people were prescribed these drugs.
Almost 14,000 were prescribed first generation antipsychotics, almost 28,000 second generation antipsychotics, and almost 6000 were prescribed both.
People aged 80 and above were more than twice as likely to be treated with an antipsychotic as those aged 40-49.
One in three prescriptions was for an older generation antipsychotic, but less than half of those prescribed them had been diagnosed with a psychotic illness/bipolar disorder.
Not everyone prescribed a newer, second generation drug had been diagnosed with a psychotic illness or bipolar disorder.
Risperidone, for example, was prescribed for anxiety in 14 per cent of cases, depression without psychoses (22 per cent), dementia (12 per cent), sleep disorders (11 per cent) and personality disorder (four per cent).
Doctors were told not to prescribe antipsychotics except as a last resort under NHS guidelines in 2004. Since then they have been repeatedly urged to limit prescriptions.
Last year the Government said it was considering a change in the law that might see doctors jailed for inappropriate prescribing.
The Department of Health says it wants to reduce the level of antipsychotic prescribing for people with dementia by two thirds and is awaiting the findings of a national audit on antipsychotics prescribing due later this year.
Prof Osborn said ‘Reducing the potential harm associated with anti-psychotics in dementia has been emphasised as a priority by organisations such as the Department of Health in England and the US Food and Drug Administration.
‘Our findings suggest that further effort is required to decrease primary care antipsychotic prescriptions in dementia, and that assessing time trends in anti-psychotic prescribing in this group is an important area for future research.’