Painkillers 'may ease agitation' in dementia patients

Dementia patient Dementia often causes agitation

Many dementia patients being prescribed "chemical cosh" antipsychotic drugs could be better treated with simple painkillers, research says.

The British and Norwegian study, published on the BMJ website, found painkillers significantly cut agitation in dementia patients.

Agitation, a common dementia symptom, is often treated with antipsychotic drugs, which have risky side effects.

The Alzheimer's Society wants doctors to consider other types of treatment.

Experts say that each year about 150,000 patients in the UK are unnecessarily prescribed antipsychotics, which have a powerful sedative effect, and can worsen dementia symptoms, and increase the risk of stroke or even death.

They are often given to patients whose dementia makes them aggressive or agitated.

But researchers from Kings College, London, and Norway speculated that the behaviour may sometimes be caused by pain, which patients were unable to express in other ways.

They studied 352 patients with moderate or severe dementia in nursing homes in Norway.

Half were given painkillers with every meal, the rest continued with their usual treatments.

Supervised treatment 'key'

After eight weeks, there was a 17% reduction in agitation symptoms in the group being given painkillers - a greater improvement than would have been expected from treatment with antipsychotics.

The researchers concluded that if patient's pain was properly managed, doctors could reduce the number of prescriptions for antipsychotic drugs.

Prof Clive Ballard, Alzheimer's Society: "Simple painkillers... had a a very, very substantial impact”

Professor Clive Ballard, one of the report authors and director of research at the Alzheimer's Society, said the finding was significant.

"At the moment, pain is very under-treated in people with dementia, because it's very hard to recognise," he said.

"I think this could make a substantial difference to people's lives - it could help them live much better with dementia."

However, he said painkillers should only be given to patients under the supervision of a doctor.

The Alzheimer's Society is issuing new guidance calling on doctors to think much harder before prescribing antipsychotics, and to look at prescribing pain medication instead.

The National Care Association said the study highlighted some of the complexities of dementia.

"Pain in itself is debilitating, so to identify it as the route cause of agitation and aggressive behaviour is a major breakthrough which will enable us to support people appropriately," said its chairman, Nadra Ahmed.

A government programme to reduce the inappropriate prescription of antipsychotic drugs is already under way in England.

The care services minister Paul Burstow welcomed the study.

"It should act as a further call for GPs to carefully examine the reason why those with dementia display agitated behaviour, rather than immediately resorting to antipsychotic medication," he said.


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  • rate this

    Comment number 22.

    Shouldn't that be "root" cause rather than "route" cause?

  • rate this

    Comment number 21.

    So is someone finally going to take on the almighty and powerful drug companies ? I think not.

  • rate this

    Comment number 20.

    one thing that puzzels me as a long term user of such drugs. why the hell are we just concerned about old people using these drugs. What about people like me in thier 40's who have already spent most of thier life on these drugs? how many years do i and many like me have? will we even have an old age to look forward to or is it a satistical heartattack at 65.

  • rate this

    Comment number 19.

    My mother suffered from nightmares and confusion caused by the inability to distinguish the nightmares from reality. Antipsychotic medicines have given her a sustained period of living at much greater peace with herself and the world dramatically reducing her trauma experiences. I'm not sure paracetamol would have had the same effect in her case.

    One size I'm sure does not fit all.

  • rate this

    Comment number 18.

    Yes, but what about the inheritance?

  • rate this

    Comment number 17.

    My sister has dementia and she was on these anti psychotics drugs for years it damaged her despite asking GP to lower the dose.
    Prior going into dreadful care home to be locked up all day long she was in hospital for 6 months and they did not pickup that she had osteoprosis she was in pain for so long it is heartbreaking

    The organisation that are suppopse to he looking after care home useless.

  • rate this

    Comment number 16.

    A huge proportion of the NHS budget, probably 95%, is currently spent on keeping very old people alive and it is simply going to get worse. Isn't it time to let time do it's thing and just let them go instead of spending Billions to keep people alive living a miserable existance slobbering in a corner with people they don't know in old people's homes ?


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