UK

Doctors told to cut anti-psychotic drugs for dementia

The use of anti-psychotic drugs for dementia patients must be cut by two-thirds by November 2011, the minister responsible has warned doctors.

Care Services Minister Paul Burstow told Panorama that GPs must "take responsibility" and drastically reduce the amount of drugs being prescribed.

Evidence suggests the drugs - used to control aggressive behaviour - have dangerous side effects.

A leading GP said most doctors agree that their use needs to be curtailed.

Mr Burstow said the evidence for cutting their use is compelling: "It kills people. It cuts their lives short. It reduces the quality of their lives. It is now time for those responsible for prescribing to take responsibility and cut the prescribing, and make sure we improve the quality of life for people with dementia."

'Chemical cosh'

A study commissioned for the government reported in 2009 that anti-psychotics are being prescribed to 180,000 patients and their side effects, including increased risk of stroke, mean that the deaths of 1,800 people a year are attributable to their use.

Mr Burstow, the Liberal Democrat minister, campaigned in opposition on behalf of dementia patients and their families to reduce the reliance on the drugs both for patients being cared for at home and those in care facilities.

Most of the drugs were developed in the 1950s for the treatment of psychosis and are not licensed for long term use with dementia.

They are prescribed "off label" for dementia patients because of their strong sedative effects and doctors have turned to them to deal with the behavioural symptoms of dementia patients.

They are supposed to be used as a last resort and only prescribed for short periods and one at a time.

Professor Tim Kendall, who wrote the current guidelines on when and how anti-psychotics should be used, is critical of how much they are being relied upon.

"By far and away the most common use is to control people's behaviours. It's nothing more than a chemical cosh," he said.

The government currently spends more than £80m on anti-psychotic drugs for dementia patients a year - and spends £8.2bn overall in the treatment of dementia.

"I don't think we're spending that £8.2 billion at all well. If we were spending it well we wouldn't have this unacceptable level of prescribing anti-psychotics in the system," Mr Burstow said.

'Virtually comatose'

Professor Steve Field, chairman of the Royal College of General Practitioners, said reliance on the drugs is part of a wider problem in the system and most GPs agree that their use needs to be reduced.

"This isn't just about prescribing, this is about the whole system. It needs to change the system is a disgrace as it is at the moment and we all need to do better."

Glynne Thompson has been attempted to wean her husband Ken, who she cares for at home, off the anti-psychotics that he was prescribed in order to control his behaviour as his dementia worsened.

"He was virtually comatose is the only way to explain it - constantly dribbling, it was like being confronted with a baby that couldn't do anything for themselves," Mrs Thompson said of the side effects of the drugs.

Panorama: What Have the Drugs Done to Dad, BBC One, Monday, 1 November at 2030GMT and then available in the UK on the BBC iPlayer.

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