Sunday, June 22, 2008

Anti-Psychotic Drugs

Doctors are continuing to prescribe anti-psychotic drugs (such as olanzapine and risperidone) to control the behaviour of elderly and confused patients, especially in hospitals and care homes, despite strong guidelines indicating that they are inappropriate for this purpose and carry dangerous side-effects.

A typical pretext for prescribing these drugs is that the patient is agitated or upset - assertiveness framed as aggression. In other words, if an old person complains about the quality of care, the easiest way to fix the problem is to slip some olanzapine into the cocoa. If there is any psychosis here, it is in the system and not in the individual.

Drugs may be justified if they provide some therapeutic benefit for the patient, but not if their purpose is merely to compensate for the inadequate care offered to old people. The BBC has found cases where the patient's life appears to have been significantly degraded or shortened by these drugs, simply to make things easier for the carers. The use of these drugs for this purpose is deeply unethical.

Meanwhile, there is a much better and cheaper remedy for agitation among demented patients: drinking more water.
Unfortunately, drinking water has a well-known side-effect, possibly resulting in more work for the care home staff, so we may see some resistance to this remedy among the less caring care homes. (Some schools also discourage water-drinking, to prevent the pupils needing to go during lessons.) When you are checking out a home for an elderly relative (or a school for a younger one), small details like the provision of water can provide good clues about the real purpose of the institution.

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