Donovan Maust, MD, a geriatric psychiatrist at the University of Michigan in Ann Arbor, recently published a study in JAMA that concluded that nearly three quarters of dementia patients had been prescribed antidepressants, opioid pain medications, anxiety drugs or antipsychotics despite "the lack of evidence that they actually ease the dementia-related behavior problems that often prompt a doctor's prescription in patients with Alzheimer's disease and related disorders". Worse, many of these drugs "have been linked to worse cognitive symptoms in old adults". That is in addition to the increased risk from unintended side effects and drug interactions.
None of the drug classes studied has received U.S. Food and Drug Administration approval for use in dementia, and Maust says that evidence supporting their off-label use is slim. But all of the drugs are associated with special risks to people in their 60s and older, including falls or dependence that could lead to withdrawal.
If someone you care for has dementia, do them a favor and keep a list of all the prescription drugs that they are taking. Ask a doctor or pharmacist what symptoms each drug is intended to alleviate and also about its proven effectiveness for those specific symptoms. These are vulnerable people who often cannot do this for themselves.
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