Antipsychotic Drugs Called Hazardous for the Elderly

A government audit has revealed that nearly one in seven elderly nursing home residents, nearly all suffering dementia are given antipsychotic drugs even though the medicines increase the risks of death and are not approved for such treatments.

More than half of the antipsychotics paid for by Medicare in the first half of 2007 were “erroneous,” costing the program $116 million for those six months.

Daniel R. Levinson, inspector general of the Department of Health and Human Services, noted that such drugs — which include Risperdal, Zyprexa, Seroquel, Abilify and Geodon — are “potentially lethal” to many of the patients and that some drug manufacturers illegally marketed their medicines for these uses “putting profits before safety.”

In response to some backlash from the audit, the Centers for Medicare and Medicaid Services said that some of the inappropriate use of antipsychotics in elderly nursing home patients is a result of drug makers’ paying kickbacks to nursing homes to increase prescriptions for the medicines.

Omnicare Inc., a pharmacy chain for nursing homes, paid $98 million in November 2009 to settle accusations that it received kickbacks from Johnson & Johnson and other drug makers for antipsychotic prescriptions.

The government auditors found that of the 2.1 million elderly patients in nursing homes during the first six months of 2007, 304,983 had at least one Medicare claim for an antipsychotic medicine. Nursing home residents received 20 percent of the 8.5 million claims for antipsychotic medicines for all Medicare beneficiaries at a cost of $309 million during those six months.

The auditors found that 83 percent of antipsychotic prescriptions for elderly nursing home residents were for uses not approved by federal drug regulators, and 88 percent were to treat patients with dementia — for whom the drugs can be lethal.

Drug interactions, over-prescribing, under-prescribing – these are huge issues. In fact my mom’s recent surgery rehabilitation has been prolonged because of this confusion. You need a good patient advocate in your corner to track these issues. Thank goodness my sister has been doing it for my mom. But if you don’t have the time with all of your other caregiving duties consider reaching out for help. That could be to a registered nurse, patient advocate, or geriatric care manager.