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Marjorie Bekaert Thomas
Advances in health and medicine.
Neurological Disorders Channel
Reported November 28, 2012

Antipsychotic Medications: Safe for All?


(Ivanhoe Newswire) – Getting older can come along with some pretty unpleasant changes to our bodies, minds, and in some cases behavior. These behavioral disturbances that can appear in old age, often due to dementia, are treated by antipsychotic medications off-label; but are the drugs safe? A new study asks this same question and finds that some of the most common antipsychotics might by neither safe nor effective for older patients. 
In the study 332 patients over the age of 40 who had been diagnosed with psychosis associated with schizophrenia, mood disorders, PTSD, or dementia were randomly given a mixture of two, three, or four common atypical antipsychotic medications.
The four antipsychotics used in the study were aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal). 
The researchers then followed the participants’ health to note any issues that may have been caused by the antipsychotics. Researchers also measured the participants’ symptoms of psychosis such as delusions and unusual behavior using the Brief Psychiatric Rating Scale. 
"While there were a few significant differences among the four drugs, the overall risk-benefit ratio for the AAPs in patients over age 40 was not favorable, irrespective of diagnosis and drug," Dilip V. Jeste, M.D., Professor of Psychiatry and Neurosciences, and Director of the Stein Institute for Research on Aging at UC San Diego was quoted as saying.
Although the patients were initially set to receive the medications for two years, the average length ended up being only six months because of side effects or the drugs were not effective. At the end of two years, about 25% of the patients developed serious adverse effects and over 50% developed non-serious adverse effects. 
The participants also showed no significant improvement on the Brief Psychiatric Rating Scale, leading researchers to conclude that the antipsychotics were not very effective in treating the symptoms of psychosis.
But with few options available, what are doctors and caregivers supposed to do to help these people? 
"When these medications are used off-label, they should be given in low dosages and for short durations, and their side effects monitored closely," Dr. Jeste was quoted as saying.
Source: The Journal of Clinical Psychiatry, November, 2012
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