Widely prescribed medications are putting dementia patients at higher risk of heart attacks, blood clots and pneumonia, a study finds.
Antipsychotic medications, which are often given to people with depression, agitation, or aggression, may cause more serious side effects than previously thought.
Experts say the findings are so concerning that doctors should avoid prescribing drugs like Risperdal and Zyprexa and look for alternatives like behavioral management therapy.
Researchers examined data from 174,000 GP consultations in England on older adults who were diagnosed with dementia between 1998 and 2018.
Some 35,339 were prescribed antipsychotics during the study (63 percent of whom were women) and their medical records were compared with those of dementia patients who were not prescribed these medications.
Previous regulatory warnings about prescribing antipsychotics for these symptoms were based on evidence of increased risks of stroke and death, but evidence of other adverse outcomes was less conclusive among people with dementia.
Academics from the Universities of Manchester, Nottingham, Edinburgh and Dundee found that dementia patients who were current users of antipsychotic medications had a twice higher risk of developing pneumonia compared to those who were not taking the medications.
The researchers also found that dementia patients taking antipsychotics had a 61 percent increased risk of having a stroke and a 43 percent increased risk of breaking a bone.
They also found a 28 percent increased risk of heart attack and a 27 percent increased risk of heart failure.
Patients with dementia who were prescribed antipsychotics appeared to have a 72 percent increased risk of kidney injury and a 62 percent increased risk of developing a type of blood clot called venous thromboembolism.
Professor Darren Ashcroft, from the University of Manchester and lead author of the study, said: “In recent years, it has become clear that more people with dementia are being prescribed antipsychotic medications, despite existing regulatory safety warnings.”
“It is important to carefully weigh any potential benefits of antipsychotic treatment against the risk of serious harm, and treatment plans should be reviewed regularly in all health and care settings.”
The increased risks appeared to be greatest in the first week after treatment, according to observational findings published in the BMJ.
The authors said their figures suggest that during the 180 days after starting medications, antipsychotic use could be associated with one additional case of pneumonia for every nine patients treated and one additional heart attack for every 167 patients treated.
Charles Marshall, professor of clinical neurology at Queen Mary University of London, said: “This evidence should prompt renewed efforts to reduce the prescribing of antipsychotics to people living with dementia.”
Dr Sheona Scales, research director at the charity Alzheimer’s Research UK, said: “The distressing symptoms of dementia, such as confusion and agitation, pose significant challenges for people living with dementia, their families and carers. .
‘Treatments that can help control these symptoms are essential for a better quality of life, but options are currently limited and, in certain circumstances, antipsychotics can be used to treat severe symptoms.
“However, these new findings suggest that these risks may be more serious than previously thought, which is particularly concerning given the increase in its use during the pandemic.”