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MPs to examine the prescribing of neuroleptics

Discussion in 'Dementia-related news and campaigns' started by Sarah Thomas, Dec 4, 2007.

  1. Sarah Thomas

    Sarah Thomas Registered User

    Oct 9, 2006
    43
    London
    #1 Sarah Thomas, Dec 4, 2007
    Last edited: Jan 8, 2008
    MPs to examine the prescribing of antipsychotics- your views wanted

    Can you help?

    Urgent call for evidence
    into the use of antipsychotics (sedatives)



    The All-Party Parliamentary Group on Dementia (APPG) is undertaking an inquiry into the prescription of antipsychotic drugs to people with dementia living in care homes.

    The APPG has decided to conduct this inquiry because carers, patient organisations and academics are expressing strong concerns about the appropriateness and safety of prescribing antipsychotics to people with dementia.

    The APPG are inviting individuals and organisations with an interest and expertise in this area to submit views on the following issues:

    1. How widespread is the use of antipsychotic drugs for people with dementia in care homes?
    2. Why are people with dementia in care homes being prescribed antipsychotic drugs?
    3. To what extent is the use of these drugs appropriate?
    4. What alternatives are there to the use of antipsychotics?
    5. What steps should be taken to ensure the appropriate prescription of antipsychotic drugs for people with dementia?

    The deadline for submitting evidence is 18 February 2008.

    There is no maximum word count and submissions from organisations will be published unless specifically requested. We would prefer responses to be sent by e-mail (as an attachment in Word) to sarah.thomas@alzheimers.org.uk

    Oral sessions are planned for February 2008.

    If you have any questions about the above, please contact the APPG Secretariat by emailing sarah.thomas@alzheimers.org.uk or telephoning 0207 423 3585.
     
  2. capybara

    capybara Registered User

    Jan 10, 2007
    32
    Anti phsychotic drugs

    :DThanks for your post. I was very concerned for a long time about my father being prescribed these drugs. As he was put on them for over a year and was never offered any conventional treatments for Alzheimers. After a battle with the local NHS trust I finally got my father re-assesed and he was taken off of them. He is now being prescribed Aricept and I am pleased to say his condition has improved.Gone is the agitation and the restless nights. After watching last nights Panorama programme I am pleased this subject has cropped up as it needs to be dealt with promptly. My gut instinct was right and at least he has a chance of normality with what is left of his Brain.
     
  3. Sandy

    Sandy Registered User

    Mar 23, 2005
    6,847
    I wonder why they have decided to limit the inquiry to people with dementia in care homes? Surely if there are concerns about the safety and appropriateness of antipsychotics those concerns should extend to people in the wider community, who might even be cared for in their own home, by relatives or by paid carers. Does the definition of care homes extend to NHS facilities, such as psychiatric assessment wards?

    Thanks,

    Sandy
     
  4. EmJ

    EmJ Registered User

    Sep 26, 2007
    230
    Scotland
    I agree totally Sandy - people in their own homes also have similar experiences with regards to sedatives. My Granny lives at home and was prescribed sedatives. At the time she had a UTI therefore we did not feel she needed them and did not give her them. She settled once the UTI cleared up.

    We were told by the old age psychiatrist who prescribed them that they can make people more 'amenable' in their homes. So it was a management issue which was more to do with the allocated time given to the visiting carers to get the job done. Having a UTI meant my granny was more confused therefore it was more difficult for the carers to complete their work in the time allocated. That is not what these drugs should be prescribed for at all. This experience left us greatly concerned and we know that if she hadn't had family to say no she would have been put on sedatives unnecessarily.

    EmJ :)
     
  5. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,439
    I'm wondering if the study is being based on people in care home primarily because of record keeping. In a care home (theoretically anyway) if a drug is prescribed it will be given, which isn't always the case in the home environment. Also, I assume they feel that in a care facility there's some element of dispassion when it comes to describing symptoms. I suppose it's a start anyway.
     
  6. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    I'd be assuming that care homes are the first because there may be fears that they scoop in all their residents to make lots of easy money, then medicate them to keep them quiet.

    Er... that is a bit simplistic and the care homes I know of are not generally profit centres.

    The fears have not been true in most homes I have seen, but I did visit one where the oft-quoted rooms full of old folk sat dozing in a semicircle around a TV set was rather obvious - so generalisation is always dangerous.

    Also care homes because there is 24 hour care there. For people in their own home, that may not be the case, and if left for long periods without someone there they may not take any medication anyway.

    just my musings....
     
  7. EmJ

    EmJ Registered User

    Sep 26, 2007
    230
    Scotland
    I can see why they would choose to focus on care homes. Channel 4 news raised this issue not long ago and they mainly focused on doctors prescribing anti-psychotics to people in care homes. My family were able to decide not to give my granny the medication whereas in some care homes this may differ.

    From my experience, we were just surprised at how quickly the doctor made his decision. He had never met my granny before and was basing his decision on observing her for less than 30 minutes and also knew she was being treated for a UTI. She had carers visiting who would have been instructed to give her the medication so it concerned us that all this could happen so quickly without really fully assessing the situation.

    A person living on their own on such medication without regular supervision raised safety concerns for us. I don't know how many people in their own homes are in a similar situation but it really concerns me. Therefore I would hope that people living on their own at home with no family will also be included in some studies in the future.

    EmJ:)
     
  8. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Hi Sarah,

    thanks so much for posting this pertinent information!

    Do you mind me asking:
    Does that mean only organisations need apply? I'm obviously not keen on writing a long thesis on the subject and to have it rejected as it is from an individual/carer. What do you think the mean by organisations?

    many thanks
    Craig
     
  9. Sarah Thomas

    Sarah Thomas Registered User

    Oct 9, 2006
    43
    London
    answering some of your points

    Hi All

    It is great to see such a positive response to this posting. In my capacity as Secretariat to the group, I will make sure your comments are fed back to members.

    I also want to take the opportunity to answer a few points that have been raised.

    In response to Craig's posting individuals can submit evidence. The APPG want to hear from family members and those caring for a person with dementia and learn about their experiences. (I will amend my posting to reflect this- many thanks for drawing it to my attention)

    In response to Sandy's posting, it is my understanding that the APPG have focused on the prescribing of neuroleptics to people with dementia in care homes because this is an area of particular concern- 40% of care home residents are prescribed neuroleptics. They have also taken into account what can be achieved by the inquiry given the scale of the issue and the APPG's resources. The APPG also want to feed the outcome of this inquiry into the national Dementia Strategy which is currently being developed.

    I agree with Jennifer's comments that it is a good place to start looking at this issue.
     
  10. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Many thanks Sarah.
    Although this has come late for my dad and many like him, I'm sure he'd like other people to benefit from our confusion and his experience.

    Individual submissions is great news. I'd better get busy.
     
  11. Sarah Thomas

    Sarah Thomas Registered User

    Oct 9, 2006
    43
    London
    Easier way to send evidence

    Hi All

    Just to let you know that you can now send your submission to the All-Party Parliamentary Group on Dementia directly from the Alzheimer's Society's website.

    To email your evidence about the use of anti-psychotic drugs in care homes go to the following link and follow the instructions:

    http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=578


    I hope that you find this helpful.

    Sarah
     
  12. DeborahBlythe

    DeborahBlythe Registered User

    Dec 1, 2006
    9,222
    Sarah, it might be helpful to actually list brand or generic names of some of the commoner neuroleptic drugs. My mother is on a couple of dugs which were originally prescribed for pain relief but seem to havea sedative effect. Deborah
     
  13. Sarah Thomas

    Sarah Thomas Registered User

    Oct 9, 2006
    43
    London
    Important info- extending deadline to submit evidence

    New Deadline for submitting evidence to All- Party Parliamentary Group on Dementia Inquiry: 18 February 2008


    Hi All

    Just a quick post to let you know that the All-Party Parliamentary Group on Dementia is extending the deadline for written evidence.

    The new deadline is the 18 February 2008.

    This is really good news for people wanting to submit evidence.

    Please do spread the word about this inquiry and do share you experiences if you can.

    Thanks
     
  14. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Thanks Sarah!

    The online form is really easy to use and going to make a submission a lot easier.

    Does the online form details go to you first? and then forwarded to the APGD? Happy with this just curious how the process works.

    Thanks for keeping us up to date and making the process easier for us. These kind of submissions can seem a little daunting for the layman/woman.

    Kind Regards
    Craig
     
  15. oldwolf55

    oldwolf55 Registered User

    Jan 24, 2008
    1
    west midlands
    MP's and the prescribing of anti psychotic drugs.

    Whilst doing some research to assist me to mark a care staff course work on dementia, I came across an article from Alzheimer Scotland, where these "medication" were/can cause major difficulties for people experiancing dementia.
    One part of the artical states that the reason for these to be prescribed are:-
    GPs prescribe often at staffs request
    Care Managers often fail to support staff i.e training/staff- resident ratios
    Poor care staff approach due to lack of the above,i.e. training etc.
    However it failed to mention one signifficant factor, that I found both now and whilst in the job of care manager. And that of the role of the proprietor or companies that own residential care homes.
    Many take on dementia residents having little or no knowledge of the subject it's effects on people and the level of care, especially 1 to 1 that is needed. But due to the increased payments as opposed to general elderly care, this is the major factor for the reason of poor staff care and increasing reliance on drugs to overcome those difficulties.
    Often boredom frustration and lack of activities lead to the challenging behaviour that staff find difficult, but due to low staffing levels and emphasis by proprietors to 'show a nice clean environment' to families and CSCI, staff and care managers are often placed under so much pressure, often for minimum wage or very long hours.
    So I think MPs should look at the funding issues and standards encouraged in homes by proprietors that then may give them the real reason so many of these drugs are being issued.
     
  16. Sarah Thomas

    Sarah Thomas Registered User

    Oct 9, 2006
    43
    London
    I hope this helps:

    There are two types of antipyschotics or neuroleptics– typical (older drugs such as haloperidol and chlorpromazine) and atypical (newer drugs such as risperidone, olanzapine, quetiapine and amisulpiride). Atypical drugs are distinguished from typical drugs because they are less likely to cause neurological side-effects (such as parkinsonism and body restlessness).
     
  17. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Hi Deborah and Sarah

    the list at the bottom of the following factsheet may also help.
    http://www.alzheimers.org.uk/factsheet/408

    Although it does not split antipyschotics or neuroleptics specifically, it is a pretty comprehensive list.

    Major Tranquillisers
    Amisulpride (Solian)
    Chlorpromazine (Largactil)
    Fluphenazine (Modecate)
    Haloperidol (Haldol, Serenace)
    Olanzapine (Zyprexa)
    Promazine (Promazine)
    Quetiapine (Seroquel)
    Risperidone (Risperdal)
    Sulpiride (Dolmatil, Sulparex, Sulpitil)
    Trifluoperazine (Stelazine)
    Zotepine (Zoleptil)
    Zuclopenthixol (Clopixol)


    Other mood stabilisers

    Lithium carbonate (Camcolit, Priadel, Liskonum)

    Anxiety-relieving drugs
    Alprazolam (Xanax)
    Buspirone (Buspar)
    Chlordiazepoxide (Librium)
    Diazepam (Valium)
    Lorazepam (Ativan)
    Oxazepam (Oxazepam)

    Hypnotics
    Chloral hydrate (Welldorm)
    Clomethiazole (Heminevrin)
    Flurazepam (Dalmane)
    Nitrazepam (Mogadon)
    Temazepam (Temazepam)
    Zopiclone (Zimovane)
    Zolpidem (Stilnoct)
     
  18. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,578
    Kent
    Now I can see what my mother was on, I`d forgotten the name.

    Chlorpromazine (Largactil) a major tranquiliser, and all she did was walk the corridors. :(
     
  19. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
  20. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London

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