A new study has concluded that behavioral therapy may be more effective in treating symptoms of Alzheimer’s and dementia than the commonly prescribed antipsychotic medication.
Learn more about the study, the benefits of behavioral therapy and the risks of antipsychotic medication for people with Alzheimer’s.
Antipsychotic Medication and Behavioral Therapy for Alzheimer’s
As most Alzheimer’s and dementia caregivers know, the disease is more than just losing memory. Aggressive behaviors, wandering, anxiety and agitation are a few of the symptoms that affect many people with the disease. These symptoms are most commonly treated with antipsychotic drugs. In fact, according to a recent report from the Government Accountability Office, 33% of people with dementia in nursing homes are prescribed antipsychotic medication.
Overall, approximately 14% of people with Alzheimer’s are taking an antipsychotic.
A new study published in the British Medical Journal challenged the widespread use of antipsychotic medication to treat dementia symptoms by concluding that antipsychotics are less effective than non-drug treatments when it comes to managing symptoms of dementia. Researchers observed over 20 years of studies and concluded that Alzheimer’s symptoms were best managed when caregivers were properly trained how to communicate with and engage the person living with dementia.
While acknowledging that medication can be necessary in emergency situations, they found that antipsychotics were about half as effective as behavioral therapy techniques and that their use can have deadly side effects that increases over time.
The United States Food and Drug Administration (FDA) agrees and has issued a warning cautioning that antipsychotics can increase the risk of mortality for people with Alzheimer’s.
Long-Term Use of Antipsychotics More Common in People with Dementia
A new study from the University of Eastern Finland is also adding to the growing body of evidence suggesting that antipsychotic medication may be harmful for people with dementia.
According to the Finnish Current Care Guidelines, use of antipsychotic medication for people with Alzheimer’s should be a short-term treatment option only for those with severe psychotic symptoms, aggression or agitation. Researchers found that antipsychotic drugs were being used 2-3 years prior to a dementia diagnosis and were most commonly prescribed 6 months following an official diagnosis.
Results were recently published in the British Journal of Psychiatry and concluded that 1/3 of people with Alzheimer’s were using antipsychotics, a rate five times higher than the control group, who did not have the disease. Researchers evaluated over 7,200 people with dementia using antipsychotics and found that 57% of the participants were using the drugs long-term, for over a year.
The researchers also note that the risk of using antipsychotics could do more harm than good in people with Alzheimer’s.
Professor Sirpa Hartikainen cautions that, “In Finland, the present incidence of antipsychotic use and the duration of antipsychotic treatment are not in line with the treatment guidelines. This is a cause of concern, because the use of antipsychotics increases the risk of severe adverse incidents such as stroke, falling and fracture, and death.”
Behavioral Therapy as a Long-Term Solution for Alzheimer’s
Dr. Helen Kales, director of the University of Michigan’s Program for Positive Aging, said of these study results:
“Why I think the caregiver interventions work is because they train caregivers to look for the triggers of the symptoms. When [caregivers] see the triggers of the symptoms, they train them to manage them… It’s inherently patient- and caregiver-centered.”
She also spoke about the risk of mortality associated with antipsychotic drugs, stating that the risk is small over the short term but increases the longer the drug is used.
The findings lead one to wonder why doctors still prescribing antipsychotic medication to people with dementia. Dr. Kales says she believes that many health care providers are not as familiar with non-drug approaches and those that are, are rarely reimbursed by insurance for non-drug options.
Have you seen the positive effects of behavior therapy on a loved one with Alzheimer’s? What was your experience like? Share your story with us in the comments below.
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