XPost: alt.society.mental-health, alt.psychology.personality   
   From: pjbrass@uswest.net   
      
   The Guardian   
      
   Inappropriate prescribing 'cutting lives short'   
      
   Sarah Boseley, health editor   
      
   Friday June 20, 2008   
      
   The use of so-called "chemical cosh" antipsychotic drugs to subdue   
   people with dementia will be curbed as part of a government strategy   
   to help the growing numbers of people with the condition.   
      
   In an interview with the Guardian the social care minister, Ivan   
   Lewis, made it clear he was unhappy with the number of dementia   
   patients, usually in care homes, who are being heavily sedated, with   
   risks to their health. "I'm really perturbed by this question of the   
   inappropriate prescribing of drugs," he said. "We sometimes dehumanise   
   stories like this - it is my or your mum and dad who is being   
   over-medicated."   
      
   Lewis, who has pledged "to drag dementia out of the dark ages",   
   announced an immediate review of the use of the drugs, which according   
   to the Alzheimer's Society are being inappropriately given to an   
   estimated 100,000 people. It will look at the use of drugs generally   
   to change the behaviour of people who may be agitated because of their   
   condition, and at why GPs were prescribing two drugs in particular -   
   the atypical antipsychotics risperidone and olanzapine - to so many   
   dementia patients in the face of official guidance that they should   
   not be used.   
      
   As long as ago as 2004 the Medicines and Healthcare Products   
   Regulatory Authority (MHRA) restricted the prescribing of these drugs   
   because of evidence that dementia patients taking them were three   
   times as likely to suffer a stroke. The dangers, said the MHRA,   
   "outweigh the likely benefits in the treatment of behavioural symptoms   
   of dementia".   
      
   Liberal Democrat MP Paul Burstow, who campaigns on this issue, said   
   immediate action was necessary and pointed out that the authorities in   
   the United States had put a "black box" warning on the drugs. "The   
   evidence is already compelling: these drugs don't treat dementia, they   
   cut lives short," he said. Lewis said the review was needed because   
   there were circumstances in which the prescription of the drugs for   
   dementia patients might be necessary.   
      
   Professor Sube Banerjee, consultant in old-age psychiatry at the   
   Maudsley hospital in London, who is advising the department on the   
   dementia strategy, said it was not easy to tell who was   
   overprescribing, but "the reality is that the scale of the   
   prescription makes it clear that these aren't just the exceptions we   
   are seeing". There are alternatives to drugs for managing patients'   
   agitation, he said. Early diagnosis and training doctors, nurses and   
   care staff to help and manage patients was key.   
      
   Neil Hunt, chief executive of the Alzheimer's Society, said the drugs   
   worsened the problems dementia patients were suffering, reducing their   
   mobility and their grip on reality.   
      
   The review will report in September, to coincide with the official   
   launch of the national dementia strategy which, in its consultation   
   form published yesterday, has three aims: to increase awareness of   
   dementia and remove the stigma of it, to ensure early diagnosis and   
   intervention, and to improve the quality of care people receive.   
      
   Link:   
   http://www.guardian.co.uk/society/2008/jun/20/longtermcare.socia   
   care?commentpage=1   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)