More behavioral Issues with Use of Antipsychotic Drugs: Study Finds
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A new study conducted by researchers at the University of Waterloo analyzed data from nearly 500,000 Canadian patients who lived in nursing homes across Canada between 2000 and 2022. It found that residents who were given antipsychotic medications showed a significant worsening of their behaviours. In fact, nearly 68 per cent of residents who used antipsychotics had more problems with their behaviour during follow-up checks.
Antipsychotics are often prescribed in nursing homes "off-label," meaning they're used for purposes not approved by health authorities like the U.S. Food and Drug Administration (FDA). The study found that 26 per cent of nursing home residents in Canada were given antipsychotics in ways not recommended by the FDA between 2014 and 2020.
Although antipsychotics are often used to calm residents with aggressive or agitated behaviour, the medications can have serious side effects. These include tremors, restlessness, rigidity, painful muscle contractions and the inability to stand and walk, which can exacerbate existing behavioural and psychological symptoms.
The study outlines the inappropriate use of antipsychotics to treat behavioural and psychological symptoms of dementia (BPSD), which can include irritability, aggression, agitation, anxiety, depression, sleep or appetite changes, apathy, wandering, repetitive questioning, sexually inappropriate behaviours and refusal of care.
Instead of turning to medication right away, researchers suggest focusing on person-centred care — getting to the root causes of a resident's behaviour and offering support in other ways. Training staff to understand the risks of antipsychotics and how to offer better care has also been linked to improved outcomes for nursing home residents, including less agitation and a better quality of life.
Reference: A Longitudinal Treatment Effect Analysis of Antipsychotics on Behavior of Residents in Long-Term Care, Leme, Daniel E.C. et al., Journal of the American Medical Directors Association, Volume 25, Issue 11, 105255
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