Findings from a recent study published in the British Journal of Psychiatry revealed that antipsychotic drugs are used by Alzheimer’s disease (AD) patients more frequently than in the general population — already 2-3 years before an Alzheimer’s diagnosis.
The team of researchers from the University of Eastern Finland also found that antipsychotics were typically commenced during the first six months after an AD diagnosis; however, the incidence of new antipsychotic users was also high later on.
To determine the incidence of antipsychotic use in relation to a diagnosis of Alzheimer’s, in the study entitled “Incidence of antipsychotic use in relation to diagnosis of Alzheimer’s disease among community-dwelling person”, Sirpa Hartikainen and colleagues used a cohort of 7,217 Finnish patients with AD and a cohort of matched controls. The researchers extracted data from the Finnish National Prescription Register, part of the Finnish MEDALZ-2005 Study, of all antipsychotics dispensed from 1995 to 2009.
At follow-up, results showed that one-third of AD patients had initiated antipsychotics. The results also revealed that the incidence of antipsychotic use in patients with AD was five times more common than in the control group who did not have a diagnosis of AD.
Results from a previous examination of antipsychotic treatment duration in the same cohort of patients revealed that the use of antipsychotics in AD patients continued for a considerably long period of time, with 57% (more than half) of patients classified as long-term antipsychotic users (more than 12 months).
The use of antipsychotics in patients with AD should be limited to a short-term treatment of agitation, aggression, and severe psychotic symptoms, according to the Finnish Current Care Guidelines. The majority of guidelines, including the American Psychiatric Association and the U.K.’s National Institute for Health and Care Excellence, recommend that the use of antipsychotics should be limited to treat symptoms of agitation, aggression, and severe psychotic symptoms when these are causing significant distress or risk of harm to the patient or to others.
“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,” said Professor Hartikainen, the study’s author.