Antipsychotic Medication

Ballard and Waite (2006) report that there is no evidence to support the efficacy of antipsychotic medication for treating dementia-related psychosis and behavioural problems. A recent study by Ballard et al (2009) indicates that there is an increased long-term risk of mortality in patients with Alzheimer’s disease who are prescribed

Antipsychotics is a drug to treat psychosis (Paranoia, delusions, hallucinations, etc.). It’s mostly used to treat schizophrenia and bipolar disorder. (3) Test batteries like PACE (Personal Assessment and Crisis Evaluation Clinic), and COPS (Criteria of Prodromal Syndromes), -they observe low level psychotic symptoms-. They used the combination of family history information, the tests that they took can identify a “high risk” group having a 20–40% risk of progression to frank psychosis within 2 years.

Side-effects such as sedation, falls and extrapyramidal signs are well-known, and more recent work indicates that neuroleptic treatment of dementia leads to reduced well-being and quality of life (Ballard et al, 2001) and may even accelerate cognitive decline (McShane et al, 1997).

Antipsychotics (also known as neuroleptics or major tranquilizers) are a class of psychiatric medication primarily use to manage psychosis (including delusions, hallucinations, or disordered thought), in particular in schizophrenia and bipolar disorder, and are increasingly being used in the management of non-psychotic disorders.

Regarding restraints it says, “The right to be free of physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraint imposed for purposes of discipline or convenience and not required to treat the residents’ medical symptoms.” (California Advocates for Nursing Home Reform, 2010). Despite this federal law against the use of psychotropic drugs as chemical restraints there are still an estimated 300,000 residents that have prescriptions written for these drugs to relieve anxiety or aggression (Jaffe, 2014). The lawyers at Paul and Perkins PA have published a nursing home abuse guide. According to this guide in 2005 the FDA mandated that a black box warning be placed on antipsychotics warning of an increased risk of mortality in dementia patients. It goes on to explain that that the longer the medication is administered; more is building up in the patients system. This accumulation puts the patient at an increased risk of heart attack and stroke. Another study that was conducted in 2007 brought out that 1 in 7 nursing home residents had Medicare claims for antipsychotic medication and out of that 1 in 7 83% of those orders for were prescribed for off label use (Smith, 2012). Meaning that these residents had no medical history of serious mental

Recently published study revealed that dementia patients who are taking antipsychotics drugs are more on risks of death. And the risk increased as dose increased. Patients, families and their care teams deserve better to prevent and treat distressing dementia symptoms. So it better to avoid this drug in dementia patient. When treating behavior problems in dementia patients, non-medicinal strategies are often more effective; however, they require time, energy, and,

Justification: They are unreliable and subject to psychotic illness and if on antipsychotic medication can lead to Parkinsonism (side effect of antipsychotics).

Dr. William E. Reichman is a specialized physician having almost 30 years of experience in the care of patients suffering with Alzheimer’s disease and related causes of Dementia. As well as he has done a research focused on Alzheimer’s drug development and the effectiveness of dementia care approaches in institutionalized settings. Since 2008, He has been the President and CEO of Bay crest Health Sciences in Toronto, and a global leader in seniors’ residential living, health care, neuroscience research, and education. He is currently a Professor of Psychiatry in the Faculty of Medicine at the University of Toronto.

An interesting and intriguing lecture that we had from Dr. Agarwal also broke down the aspects of delirium, dementia, and Alzheimer’s and how they affect one another. Throughout her lecture, I learned that it is important for not just social workers, but doctors and all health care professionals to be aware of the medications that the elders are on that could cause delirium. Sometimes pills are giving to the elders to treat a condition that they have without recognizing the mental consequences that they may cause. She also informed us that most doctors are focused on the here and now and

Dementia is a group of symptoms caused by other disorders that affect a person’s cognition, it affects short and long-term memory that results in impaired judgment, personality changes and problem solving abilities (Wagner, Johnson & Kidd, 2013). Changes in personality and judgement can lead to agitation and aggression in these patients. One of the reasons patients present in health care facilities is related to the caregiver being unable to handle these type of behaviors (Ballard, Corbett, Chitramohan, Aarsland, 2009). The focus of this study is the use of antiepileptic drugs (AED’s) also called anticonvulsant medications in patients that have dementia with aggression and agitation living in health care facilities.

Atypical Antipsychotics are most often used. These second-generation medications are preferred due to the fact that they have a lower risk of serious side effect which can better treat this mental illness. These medications include: Aripiprazole (Abilify), Asenapine (Saphris), Clozapine (Clozaril), Iloperidone (Fanapt), Lurasidone (Latuda), Olanzapine (Zyprexa), Paliperidone (Invega), Quetiapine (Seroquel), Risperidone (Risperdal), and finally Ziprasidone (Geodon). Many of the first-generation antipsychotics have frequent and potentially significant neurological side effect, like Tardive Dyskinesia (a movement disorder) that may not be reversible. However, the medication within this group include, Chlorpromazine, Fluphenazine, Haloperidol

During my first clinical rotation as a nursing student, I was assigned to care for several older adults suffering from dementia. Although all of my patients ranged in severity from mild to severe progression of dementia, they all experienced moments of agitation, anxiety, or disturbed behaviors related to their disease. It occurred to me after careful review of several patient charts that despite often being prescribed pharmaceutical regimes for other comorbidities, these patients were rarely prescribed medications, besides those to control anxiety, specifically targeted at treating their progressing dementia. Through some research I discovered that the significant number of individuals affected with dementia is a growing public health concern in part due to the current limited ability of pharmaceutical treatments to treat the disease (Samson, Clement, Narme, Schiaratura, & Ehrle, 2015). This revelation began my interest in current nonpharmacological treatments being implemented in controlling adverse behaviors and feelings in patients diagnosed with dementia.

Undoubtedly, the human body naturally begins to decline as a person ages. This decline can easily increase the amount of medication an individual is prescribed. Often it is difficult for older individuals suffering with cognitive impairment to remember medication names, dosages, or the medication’s purpose. These individuals are at a higher risk for medication errors, adverse

This cost barrier may cause them to divide their medications to save budget or take their medications only during exacerbation period. On top of that, a lot of elderly facing problems to adhere towards their medications as majority of them are having a lot of diseases and complications, which lead to polypharmacy. Their forgetfulness worsened the fact that those medications have to be taken at different frequency, timing, and method to take.

Upon completion of the study, Gray et al. found that the risk for dementia increases with higher cumulative anticholinergic use. This conclusion was made following a