Posted by John Ager on 01 December 2011.

Off label use of antipsychotic medications by nursing homes in patients with dementia is likely killing them.  Antipsychotics are supposed to be used to treat used to treat bi-polar disorder and schizophrenia.  Doctor prescribing these drugs know that they increase the risk of death in seniors because they raise blood sugar and cholesterol levels and cause weight gain.  They can cause many other undesirable side-effects as well.  In fact, the labels for antipsychotic drugs specifically caution against the use of the drugs for patients with dementia.  Still they are regularly prescribed for 14% of all nursing home patients, a far greater number than those who suffer from psychosis.  Indeed, 83% of all Medicare claims for antipsychotic medications are for patients with dementia.  Why?  Not because the drugs help the patient.  They have a sedative effect making aggressive patients easier to manage, often putting them to sleep and, eventually killing many.  Maybe the nursing homes can begin electroshock therapy too.  That’s been found to have a calming effect in psychotic patients as well.  It all sadly reminds of the movie “One Flew Over the Cuckoo’s Nest”

Despite repeated government warnings against such off label prescriptions, the practice continues unabated.  Why?  $$$$$$$$$.   And who pays for this unique and lethal management technique?  We do, of course. Fortunately, the U.S. Department of Health and Human (and Humane) Services is now recommending requiring nursing homes to pay for inappropriately prescribed medication or barring them receiving Medicare reimbursement altogehter.  Will it work?  We’ll see.

The humane treatment of those least able to care for themselves is the hallmark of a civilized society.  Medicating patients to death to “make it easier on everyone” clearly is not the directing we should be heading.  Disgusting.