Health warnings failed to curb use of antipsychotic drugs in seniors: study
27.08.2008 00:02
Health
- Source: cbc.ca
Three warnings from Health Canada on the risk of death and stroke among seniors taking antipsychotic drugs failed to reduce the prescription rates of those drugs, according to researchers who suggest health warnings are ineffective at protecting patients. Between October 2002 and June 2005, Health Canada issued three warnings of increased risk of death or stroke in elderly patients with dementia who take atypical antipsychotic drugs. In the 1990s, antipsychotics such as Zyprexa (olanzapine), Seroquel (quetiapine) and Risperdal (risperidone) were developed for schizophrenia and other psychiatric conditions. Of the three drugs, only risperidone is approved by Health Canada to treat symptoms of aggression and psychosis in elderly patients with dementia, although doctors may prescribe conventional and atypical antipsychotic drugs off-label for dementia. "The three warnings about serious adverse events associated with use of atypical antipsychotic agents in elderly people with dementia had a limited effect on the prescription rates of these agents," Dr. Geoffrey Anderson of the department of health policy, management and evaluation at the University of Toronto and his colleagues write in Tuesday's issue of the Canadian Medical Association Journal. "We also found that the overall rates of use of these drugs actually increased between the first warning in 2002 and the end of our follow-up in 2007. "This finding highlights the limited impact of warnings and suggests that more effective approaches are needed to protect vulnerable populations from potentially hazardous medications." There was a small relative decrease in predicted growth of the use of atypical antipsychotic drugs: - 5.0 per cent after the first warning.
- 4.9 per cent after the second warning.
- 3.2 per cent after the third warning.
The researchers found the overall prescription rate of antipsychotic drugs among patients with dementia increased by 20 per cent, from 1,512 per 100, 000 elderly patients in September 2002, the month before the first warning, to 1,813 per 100 000 in February 2007, 20 months after the last warning. Info needed on alternativesA comprehensive, co-ordinated approach between Health Canada, drug manufacturers, private and public drug insurers and physicians is needed, the study's authors say. In both the antipsychotic case and warnings on use of antidepressants in children, the warnings did not achieve the desired outcome, Dr. Laurence Katz of the University of Manitoba said in a commentary accompanying the study. The results suggest doctors will return to what they know, despite documented risks, if they are not given other options. "Health care warnings should provide accurate, explicit and complete information about the risks and efficacy of the identified treatment in addition to providing the same information on alternative treatments," Katz wrote. For seniors with dementia, alternative drug and behavioral treatments could be considered, although there is limited evidence to support their use, he said. Katz agreed with the study's authors that to improve drug warnings, Health Canada will likely have to collaborate with the pharmaceutical industry and physicians and will need access to all data — published and unpublished. The effectiveness of atypical antipsychotics for elderly patients with dementia was not shown in a randomized control trial and consensus meeting on the topic. But to reach that conclusion, regulatory agencies and authors had to get access to unpublished reports of trials, mostly from pharmaceutical companies, Katz noted. Story Tools: E-MAIL | PRINT | Text Size: SMLXL | REPORT TYPO | SEND YOUR FEEDBACKRelatedInternal LinksIN DEPTH: Seniors and drugsDangerous drugs continue to be prescribed to seniors: CBC reportOlder psychiatric drugs could be fatal for seniors: FDAAntipsychotic drugs linked to higher risk of death among seniorsExternal LinksPrescription rate study, Canadian Medical Association JournalHealth care warning commentary, CMAJ(Note: CBC does not endorse and is not responsible for the content of external sites - links will open in new window) Health HeadlinesHigh levels of toxic metals found in herbal medicines sold onlineAbout one in five Ayurvedic remedies used in traditional Indian medicine contained toxic lead, mercury or arsenic, say researchers who bought the products online.Belief in cancer myths risky: reportPeople worldwide have a poor understanding of what causes cancer and therefore underestimate the importance of factors they can control, like diet and alcohol consumption, according to a report released on Wednesday.Premature birth tied to infectionsUndiagnosed infections may be causing more premature births than thought, say researchers who found nearly 15 per cent of samples from women in pre-term labour contained bacteria or fungi.Health officials debate standards for food allergy warningsHealth officials in the U.S. and Canada are debating setting standards for food allergy warnings, amid increasing concern that consumers are so confused that they're starting to ignore the warnings.Test results pending in 4 Alberta listeriosis casesAlberta doctors are waiting for test results from four of the eight cases of listeriosis reported in the province so far this year to see whether they're linked to the deadly outbreak connected to tainted deli meat. Health FeaturesIN DEPTHFood safetyFrequently asked questions about listeriaASTHMABoys vs. girlsNew thinking about the disease in youngstersFOODHealthy barbecueAudio: Dr. Peter Lin on reducing cancer risks (6:35)IN DEPTHMental healthCanadians earn failing grade for attitudeIN DEPTHWest Nile  HEALTHMemorySurprising things that affect itPeople who read this also read …
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