Psychiatry, It's A Killing.: Dementia

Showing posts with label Dementia. Show all posts

Thursday, May 24, 2018

Study Links Some Antidepressants, Bipolar Meds, Parkinsons Drugs To Dementia

CBS SF Bay Area
May 23, 2018 at 11:55 pm
Filed Under:Anticholinergics, Dementia

SAN FRANCISCO (KPIX 5) — New research is raising important questions as to whether certain widely-prescribed drugs may be linked to dementia.

Globally, 50 million people are living with dementia, and it’s predicted to increase around the world to 132 million by 2050.

Doctors and public health experts realize that countries need to develop preventive health policies to reduce the neurodegenerative condition.

Read More

Wednesday, October 26, 2016

Antidepressant Use Linked To Dementia

madinamerica

Marta PagánOrtiz

October 25, 2016

The authors of a study published in Alzheimer Disease and Associated Disorders found that elderly individuals using antidepressants were at significantly higher risk for dementia when compared with both depressed and not depressed nonusers. The study, which is one of the few long-term studies focusing on associations between antidepressants and dementia, followed a large group of participants for up to 18 years.

“In this elderly primary care patient cohort, we found that SSRIs users were at significantly higher risk for incident dementia when compared with not depressed nonusers and also when compared with nonusers with depression. Patients who were taking non-SSRIs also showed significantly higher risk for incident dementia when compared with nonusers without depression.”

Antidepressants, including selective serotonin re-uptake inhibitors (SSRI), are commonly prescribed drugs in the U.S. Despite studies that have suggested these could haveneuroprotective effects and that they can improve cognitive function in patients with Alzheimer’s dementia, these results are not consistent. Studies conducted with different populations have also found conflicting results with some finding that older antidepressants were associated with a reduced rate of dementia and others have found antidepressant use associated with cognitive impairment. Further, as the authors, led by Dr. Chenkun Wang, point out, elderly individuals are often underrepresented in clinical trials, therefore little is known about this antidepressant use in this population, particularly those with unimpaired cognitive functioning.

Over a span of two years (i.e. 1991-1993) 3,688 patients from a private care practice were enrolled in the study and included in the analysis – all of whom were 60 years of age or older. The researchers used medical history information from inpatient, outpatient, and emergency room records. Among the data retrieved were diagnoses of depression and dementia. Data regarding their antidepressant medication prescription and dispersal was also retrieved from their electronic medical record. Patients were divided into 5 groups:

Prescribed only SSRIs
Prescribed only non-SSRIs anti-depressants
Prescribed mixed anti-depressants (non-SSRIs & SSRIs)
Participants diagnosed with depression but not prescribed antidepressants (nonusers with depression)
Participants diagnosed who were not diagnosed with depression nor received antidepressants (nonusers without depression)

Results revealed that participants who were on SSRIs or non-SSRI antidepressants had a higher risk of dementia than the individuals diagnosed with depression who were not prescribed antidepressants. In addition, those who were on either type of antidepressant were at a higher risk of dementia than nonusers without depression.

Despite the limitations of the study, which include prescribing bias (e.g. doctors prescribing SSRIs to adults with cognitive impairments) and lack of depression and dementia severity measures, this is not the only study to yield these associations. A recent article on Medscapereporting on SSRIs and sleep disruption found that these antidepressants could cause significant sleep problems in the elderly, which could contribute to neurodegeneration leading to dementia. The authors of the study, which was presented at the Institute of Psychiatric Services: The Mental Health Services 2016 Conference, warn against ignoring sleep issues and side-effects of SSRIs and reiterate the importance of psychotherapy and holistic alternatives for elderly populations.

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Wang, C., Gao, S., Hendrie, H. C., Kesterson, J., Campbell, N. L., Shekhar, A., & Callahan, C. M. (2016). Antidepressant use in the elderly is associated with an increased risk of dementia.Alzheimer Disease & Associated Disorders, 30(2), 99-104. (Abstract)

Thank You MIA and Ms Pagan-Ortiz.

Thursday, April 2, 2015

Antipsychotics Even Riskier For The Elderly Than Previously Thought

madinamerica;

Antipsychotic medications that are commonly being used to help control behaviors in elderly people with dementia seem to be causing premature deaths at higher rates than previously thought, according to a study in JAMA Psychiatry.

The University of Michigan-led team examined records for nearly 91,000 elderly veterans with dementia between 1998 and 2009, who had been treated with either of several psychiatric drugs or had received no psychiatric drugs at all. They then calculated the "number needed to harm" (NNH), or the number of people who had to be taking a particular class of psychotropics in order for one of them to die within six months.

"The results, published this week in JAMA Psychiatry, showed that mortality risks statistically increased in patients taking antipsychotics to reduce symptoms of dementia, compared with individuals not being treated," reported Psychiatric News. "Haloperidol was observed to be the riskiest -- with one death per every 26 individuals taking the drug. Risperidone had a NNH of 27, followed by less risky olanzapine and quetiapine with NNHs of, respectively, 40 and 50. The researchers also observed the mortality risk for older adults with dementia who took antidepressants. The mortality risks were lower -- with one person dying for every 166 individuals taking the medication."

The researchers concluded in their abstract, "The absolute effect of antipsychotics on mortality in elderly patients with dementia may be higher than previously reported and increases with dose."

"We hope this creates a dialogue about the advantages and disadvantages of antipsychotic and other psychotropic use as first-line treatment strategies for behavioral symptoms," one of the researchers told Psychiatric News.

"These risks are two to four times higher than previously cited in the medical literature," reported MinnPost. "Another troubling finding was that people prescribed haloperidol — the riskiest of the drugs — were more likely to be unmarried, African-American or living in facilities with fewer beds for patients."

Maust DT, Kim H, Seyfried LS, et al. Antipsychotics, Other Psychotropics, and the Risk of Death in Patients With Dementia: Number Needed to Harm. JAMA Psychiatry. Published online March 18, 2015. doi:10.1001/jamapsychiatry.2014.3018. (Abstract)

Are antipsychotic drugs more dangerous to dementia patients than we think? (University of Michigan Health System press release on ScienceDaily, March 18, 2015)

Antipsychotic drugs are riskier for older dementia patients than previously thought, study finds (MinnPost, March 19, 2015)

Mortality Risk High for Dementia Patients Taking Antipsychotics, Study Finds (Psychiatric News Alert, March 20, 2015)

--Rob Wipond, News Editor