GPs still prescribing psychotic drugs for dementia patients

18/06/2008

The BBC's File On 4 has questioned more than 355 GPs and discovered that more than half are regularly prescribing the powerful psychiatric drugs risperidone and olanzapine to elderly dementia patients - despite a safety warning issued four years ago.

 

In 2004 the former Committee on Safety of Medicines (CSM) considered research evidence for risperidone and olanzapine - usually used for conditions such as schizophrenia - and found that their use in elderly dementia patients raised the risk of strokes. They sent an urgent message to GP's warning them of the danger.

 

But the BBC found that only 15 doctors out of 355 questioned said they would never use anti-psychotic medication for dementia patients. 

The rest cited several symptoms for which they would prescribe such drugs, including aggression, inappropriate behaviour, disinhibition, wandering or being noisy.

 

Risperidone was the most popular, with 72% of the doctors questioned saying they had prescribed it for dementia patients in the past four years, and some 53% has similarly prescribed olanzapine. The questionnaire also found that some doctors prescribed anti-psychotic drugs to 90% of their dementia patients.

 

Dr Lewis Morrison, chair of the community care committee of the British Medical Association (BMA) told File On 4: "I think it (prescribing the drugs) happens because situations arise where the patient is physically very disturbed and is at risk of doing violence to themselves or others.

 

"I'm not going to pretend that every single incidence of the usage of those drugs [risperidone and olanzapine] in the face of the advice is appropriate. But I would say that training in the use of these drugs is absolutely key or, more importantly, perhaps training in the use of other things including non-drug treatments."

 

The National Institute for Health and Clinical Excellence described the findings as "horrifying" and suggested that the doctors concerned should be disciplined.

 

To hear the full findings in the research, listen to File On 4, Radio 4, Sunday 22nd June 1700 BST, or catch up at Radio 4's Listen Again on the website below.