If you read the latest academic or other dementia Journals, you may have seen two articles available for loan in Sydney, and of interest to anyone in the dementia space. Professor Henry Brodarty (psychogeriatrician) has created a DVD titled Antipsychotics and dementia : managing medications, where he, Dr Julian Pierre (GP) and Tim Perry (consultant pharmacist) discuss the challenge of deprescribing antipsychotics for dementia patients and look for alternative solutions for symptoms. On page 7 of the Journal of dementia care: for all who work with people with dementia (vol 25 no 6 November December 2017) Antipsychotic use “unacceptable the Welsh commissioner says, …we have been stuck in a damaging cycle of prescribing antipsychotics for people with dementia, despite the fact that there are minimal benefits and despite the fact that there are there are lots of harms…”
Whilst I disagree with this statement on the Halting Antipsychotic use in Long Term care (HALT) Project website that “The majority of people with dementia will experience Behavioural and Psychological Symptoms (BPSD) during the course of their illness.”, I don’t even agree that BPSD exists in more than 10% of people with dementia, if at all, but I do agree antipsychotics need to be reduced as they have a Black Box Warning and are doing much more harm than good. We must work together to reduce the use of antipsychotics as a matter of urgency.
Whilst I’ve not seen the DVD referred to above, I’ve known of the HALT program and the RedUSE program in Tasmania since they were first reported on, and have read the article by the Welsh Commissioner in the JDC. Anyway, enough ranting about the abusive use of antipsychotics in dementia and aged care, today I’ve been inspired me to purchase a book today called “Drug-Induced Dementia : A Perfect Crime” by GE Jackson, which I have had on my wish list for some time, but as we have a budget, I didn’t have the spare funds last year. It is going to be an interesting read, especially as it was published in 2009. I wondered if it might be too old to bother reading, but I wanted to see what the author back then thought, compared to what we see happening now with the use of drugs as a form of chemical restraint in aged and dementia care.
The Book Depository website from where I have purchased it says:
“Under the influence of declining birth rates, expanding longevity, and changing population structures around the world, the global prevalence of senile dementia is expected to increase more than four-fold within the next forty years. Within the United States alone, the number of affected individuals over the age of 65 is expected to rise exponentially from 8 million cases (2% of the entire population in the year 2000), to 18 million retirees (roughly 4.5% of the national census in the year 2040). Although they are striking, these statistics quite likely underestimate the scope of the coming epidemic, as they fail to consider the impact of under-diagnosis, early-onset disease, and the potential for a changing incidence of illness in the context of increasingly toxic environments. In the face of this imminent crisis, concerned observers have called for policies and practices which aim to prevent, limit, or reverse dementia.
Drug-Induced Dementia: A Perfect Crime is a timely resource which reveals why and how medical treatments themselves – specifically, psychopharmaceuticals – are a substantial cause of brain degeneration and premature death. A first-of-its-kind resource for patients and clinicians, the book integrates research findings from epidemiology (observational studies of patients in the “real world”), basic biology (animal experiments), and clinical science (neuroimaging and autopsy studies) in order to demonstrate the dementing and deadly effects of psychiatric drugs. Highlighted by more than 100 neuroimages, slides of tissue specimens, and illustrations, the book uniquely describes: O the societal roots of the problem (target organ toxicity, regulatory incompetence, and performativity) O the subtypes and essential causes of dementia O the patterns, prevalence, and causes of dementia associated with antidepressants, antipsychotics, anxiolytics, mood stabilizers, and stimulants and O the actions and reforms which patients, providers, and policy makers might immediately pursue, in an effort to mitigate the causes and consequences of this iatrogenic tragedy.”
I’m looking forward to reading it, maybe on a long flight some time later this year!