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Suffolk: Warning over use of anti-psychotic drugs

PUBLISHED: 09:00 21 September 2011

Dr Rob Butler

Dr Rob Butler

A LEADING consultant has warned of the dangers of unnecessarily giving anti-psychotic drugs to dementia patients, claiming many see no benefit at all.

Dr Rob Butler spoke out as a new report appeared to show that NHS mental health services in Suffolk were making progress in providing alternative care, rather than using pills as a “quick fix”.

Experts have warned that anti-psychotics, which are sometimes used in response to symptoms such as aggression, agitation, wandering and shouting, brought side-effects such as increased risk of strokes and premature death.

Suffolk is facing a huge increase in the number of people aged over 65 diagnosed with dementia, with numbers set to rise from 10,210 this year – costing the NHS £2.4million annually – to 16,352 in 2025.

The Prescribing Observatory for Mental Health Services (POMH) at the Royal College used figures from 53 trusts and more than 10,000 dementia patients to analyse the use of anti-psychotic drugs.

The report, which reviewed 200 patients from the Suffolk Mental Health Partnership NHS Trust, found that 19% of dementia patients nationally were given anti-psychotic drugs.

In Suffolk, it was found that 11% of patients – 22 of the 200 reviewed – had been given the drugs. Of those, four also had a psychotic illness.

A separate survey found around 20% of people with dementia living in Suffolk nursing homes were given anti-psychotics compared to 22% nationally.

The report, which comes as World Alzheimer’s Day is marked today, found that older patients aged over 90 were less likely to be given anti-psychotics with the highest proportion being given to under 70s.

Dr Butler, consultant psychiatrist in older people’s mental health, said: “Suffolk’s low figures could suggest that staff are providing better alternative care, with better interactions between staff and patients and more personalised care.

“Many people receiving anti-psychotics are not deriving any benefit from them.

“The low rates in Suffolk are good news because they mean that fewer people are at risk of the harms these drugs can cause.”

David Jarrold, lead specialist nurse for the trust, said administering drugs to dementia problems had previously been seen as a “quick fix” and staff were now trained to find out the underlying cause of any problem, which could be pain, hunger, heart failure or infection.

“It can take time but in most cases patients are trying to communicate an unmet need and we see it as no different to other types of challenging behaviour, in anybody.

“We work with people to get any many ideas as possible as to what might be causing their behaviour.”

He added: “We request them (anti-psychotics) very rarely now, only to target something that is documented.

“We keep the treatment under review and if there are no improvements then we stop using them.”

The National Dementia Strategy has a set a target of reducing the prescribing of anti-psychotics by two thirds in two years.

It is thought cutting antipsychotics could save 1,800 lives nationally and cut strokes by 1,620 as well as save money. It is estimated that only 20% of those given the drugs show improvement.

About 700,000 people in the UK have dementia, which costs £17billion a year to the public purse.

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