By Scott
Hensley, NPR News
(This story comes from NPR's health blog Shots.)
May 13, 2011--About 1 in 7 elderly residents
of nursing homes receives a so-called
atypical antipsychotic medicine, a federal
audit finds, despite an increased risk of
death when the medicines are used to manage
dementia in older people.
A review of medical records found that most
of the atypical antipsychotics were being
used outside the Food and Drug
Administration's approval of the medicines
to treat schizophrenia and bipolar disorder.
Indeed, About
1 in 7 elderly residents of nursing homes
receives a so-called atypical antipsychotic
medicine, a federal audit finds, despite an
increased risk of death when the medicines
are used to manage dementia in older people.
"Despite the fact that it is potentially
lethal to prescribe antipsychotics to
patients with dementia, there's ample
evidence that some drug companies
aggressively marketed their products towards
such populations, putting profits before
safety," wrote Daniel Levinson, Inspector
General of the Department of Health and
Human Services, whose office did the
analysis.
The top three drugs, based on the number of
claims found in the 2007 audit, were:
1. Seroquel from Astra Zeneca
2. Risperdal from Johnson & Johnson
3. Zyprexa from Eli Lilly.
To
Levinson's point on marketing, nursing home
pharmacy chain Omnicare agreed to pay the
federal government $98 million in 2009 to
settle charges it took kickbacks from J&J to
boost sales of Risperdal.
The OIG made some recommendations for
improvement, such as better education and
halting payments for unnecessary use of
medicines.
Despite the risks, the prescription of the
medicines isn't likely to disappear. As
psychiatrist Daniel Carlat told the New York
Times, there aren't very many other good
options. "Doctors want to maximize quality
of life by treating the patient's agitation
even if that means the patient will die a
bit sooner," Carlat said.
Indeed, as NPR's Joanne Silberner reported
back in 2005 when warnings were raised about
both the newer, atypical antipsychotics and
their predecessors it treating the elderly,
a doctor told her he would continue to use
the medicines carefully and in low doses
because they still carried benefits.
