This is a controversial matter……. I don’t even know what to say about it……….. my mother is on antipsychotics that were given to her by a trained psychiatrist to “stabilize” her during her month-long stay at a geriatric psych unit. They do this……….. stabilizing…………… because many facilities (even the “memory care” units) won’t accept behavioral patients unless they are medicated……………… it’s a lose-lose situation, but it’s certainly not uncommon………………. And yes, we all know about “black box” warnings.
So what do you do? For those of us coping with a behavioral parent, our options are limited, and often the only course of action is Seroquel, Lithium, Depakote, Zyprexa, two or more of the above, and the list goes on………………………
Is it a disturbing practice? Yes.
Is there a choice? In our case, no. We had no choice.
Fortunately, Washington, with their first-rate, life-long health care, is on the case……………….
Inside voice…………… I wonder if the esteemed senators below would be willing to take in behavioral dementia patient who has been asked to leave yet another memory care unit or assisted living facility?
So, what do you think about antipsychotics?
U.S. Senators Herb Kohl, D-Wis., Chuck Grassley, R-Iowa, and Richard Blumenthal, D-Conn., today filed an amendment seeking to combat the costly, widespread and inappropriate use of antipsychotics in nursing homes.
“The overuse of antipsychotics is a common and well-recognized problem that puts frail elders at risk and costs taxpayers hundreds of millions of dollars each year,” Kohl said. “We need a new policy that helps to ensure that these drugs are being appropriately used to treat people with mental illnesses, not used to curb behavioral symptoms of Alzheimer’s or other dementias.”
“This amendment responds to alarming reports about the use of antipsychotic drugs with nursing home residents,” Grassley said. “It’s intended to empower these residents and their loved ones in the decisions about the drugs prescribed for them.”
“This measure is responsive to mounting evidence that antipsychotics are being misused and overused in the nursing homes we trust to care for our loved ones,” Blumenthal said. “The amendment will do what is necessary to curb this deeply concerning practice, putting the power to make key health care decisions back into the appropriate hands and eliminating unnecessary costs to taxpayers.”
The amendment to S. 3187, the Food and Drug Administration Safety and Innovation Act would require the Health and Human Services Secretary to issue standardized protocols for obtaining informed consent, or authorization from patients or their designated health care agents or legal representatives, acknowledging possible risks and side effects associated with the antipsychotic, as well as alternative treatment options, before administering the drug for off-label use. While the Food and Drug Administration (FDA) has approved antipsychotic drugs to treat an array of psychiatric conditions, numerous studies conducted during the last decade have concluded that these medications can be harmful when used by frail elders with dementia who do not have a diagnosis of serious mental illness. In fact, the FDA issued two “black box” warnings citing increased risk of death when these drugs are used to treat elderly patients with dementia.
Last year, the Health and Human Services Office of the Inspector General (HHS OIG) issued a report showing that over a six-month period, 305,000, or 14 percent, of the nation’s 2.1 million elderly nursing home residents had at least one Medicare or Medicaid claim for atypical antipsychotics. The HHS OIG also found that 83 percent of Medicare claims for atypical antipsychotic drugs for elderly nursing home residents were associated with off-label conditions and that 88 percent were associated with a condition specified in the FDA box warning. Further, it showed that more than half of the 1.4 million claims for atypical antipsychotic drugs, totaling $116.5 million, failed to comply with Medicare reimbursement criteria. The amendment also calls for a new prescriber education program to promote high-quality, evidence-based treatments, including non-pharmacological interventions. The prescriber education programs would be funded through settlements, penalties and damages recovered in cases related to off-label marketing of prescription drugs.
I honestly hope that the sponsors of this bill have intimate knowledge of “Alzheimer’s or other dementias” behavior. I, too, didn’t like the idea of antipsychotics until my mother became aggressive, combative – even violent – with me. Her FTD has stripped her of any filter for inappropriate behavior. Her very small dose of Seroquel enables her to control some of her behaviors, not all of them, but it also enables my sister and me to enjoy her company again. I agree it’s a fine line but, hopefully, the government won’t make the nasty behaviors of FTD more difficult for caregivers.
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The newer generation so called ‘atypical’ antipsychotics have been heavily pushed by the drug companies,on children,veterans for PTSD and the elderly.
Eli Lilly’s Zyprexa franchise made them $65 billion.Lilly was fined $1.4 billion for Zyprexa fraud.
-Daniel Haszard FMI zyprexa-victims(dot)com
anyone thinking that the use of anti-psychotics is questionable has never been bitten by their mother whilst she is experiencing a psychotic break…each time we attempted titrating down her dosage, she tilted. I believe in the use of anti-psychotics for the comfort and safety of the patient and those around them.
My mother is off of Seroquel for the first time in 2+ years. She is now verbal again, shows emotion, hugs, kisses and responds to us appropriately. I know that this may be short lived, but I will take it. I too believe in the use of anti-psychotics for the comfort and safety of the patient and those around them — but I think that in my Mom’s case the drug was over used just for the convenience of the care givers so that Mom wouldn’t wander at night and slept when the staff was reduced overnight.