Another WSJ article on antipsychotics (12/20/07)

The Wall Street Journal is really hitting hard on this topic — nursing home use of antipsychotics. They’ve had two front page articles in 2 weeks. Here are some excerpts from today’s article:

* “Use of a new generation of antipsychotic drugs to control the behavior of dementia patients has surged in recent years, despite the Food and Drug Administration’s ‘black box’ warning labels that these drugs can increase the risk of death for elderly dementia sufferers.”

* “About 30% of nursing-home residents are on antipsychotic drugs, according to the Centers for Medicare & Medicaid Services, most of them on newer ones called atypical antipsychotics.”

* “The challenge of caring for rising numbers of seniors who suffer from dementia and the behavior problems that can stem from it has provoked a wrenching debate among nursing-home operators, regulators and families. There are few effective medicines to manage the outbursts of Alzheimer’s patients — behavior that can overwhelm family members trying to care for a loved one at home, and strain the resources of those trying to maintain order in nursing facilities.”

* “Medicaid in 2005 spent $5.4 billion on atypical antipsychotic medicines — more than it spent on any other class of drugs… Atypical antipsychotics are approved for schizophrenia and bipolar disorder. But in what is known as ‘off label’ use, doctors often prescribe the drugs to elderly people with dementia.”

* “According to CMS, nearly 21% of nursing-home patients who don’t have a psychosis diagnosis are on antipsychotic drugs. A 2005 study, published in the Archives of Internal Medicine, found antipsychotics were prescribed not only for psychosis, but for depression, confusion, memory loss and feelings of isolation, says the study’s author Becky Briesacher.”

* “Family members can object to the use of such drugs. But they risk having the facility threaten to discharge their relative on grounds that they pose a danger to themselves or others.”

Here’s the link to the article:

Nursing Homes Struggle To Kick Drug Habit
New Therapies Sought For Dementia Sufferers;
Music and Massages
Wall Street Journal
By Lucette Lagnado
December 20, 2007; Page A1