Doctors prescribe antidepressant trazodon more often to seniors with long-term dementia as a result of increased concern about antipsychotics. However,…
Doctors prescribe antidepressant trazodon more often to seniors with long-term dementia as a result of increased concern about antipsychotics.
However, there are many unanswered questions about drug safety in dementia patients and Canadian researchers decided to determine if it is a safer alternative to antipsychotics.
Their study, published on Monday in the Canadian Medical Association Journal, found seniors in long-term care taking trazodon at increased risk of fall and fractures. The risks are in line with the fall and the risk of cracking associated with antipsychotics, found the research.
Leader author Jennifer Watt, a geriatrician at Toronto’s Mikaels Hospital, said the results would send the message. Trazodon is not necessarily a safer alternative to antipsychotics for dementia patients in long-term care.
“For a number of years, we knew that antipsychotics were bad,” said Dr. Watts in an interview. “We did not know that other drugs were as bad.”
Many seniors with long-term dementia received antipsychotic drugs to handle agitation, aggression and other common symptoms of the disease. Nevertheless, there is little evidence that showing these drugs is effective and there are concerns about dangers such as increased risk of heart attack, as well as fall and fractures. This has led to many healthcare professionals calling for non-drug-related treatments for the disease.
A number of studies published in the last decade have suggested antipsychotics with serious risks including death, which has escalated the need for alternative therapies. Dr. Watt said that trazodone is increasingly filling the void of antipsychotics. The medication is believed to help relieve some of the challenging symptoms of dementia, such as aggression.
According to the study, one third of Ontario seniors with dementia living in a long term care in 2013 were given antipsychotic drugs to deal with their symptoms. Just over 21 percent received trazodone.
Dr. Watt’s study focused only on the fall and fracture regimen associated with trazodone and did not evaluate any other potential safety concerns.
She looked at Ontario’s health data for nearly 6,600 seniors in long-term care, considering a new prescription for trazodone and 2,875 released an antipsychotic drug.
As healthcare professionals move to rely on trazodon as an alternative for dementia patients, Dr Watt said that they should understand the drug is not necessarily safer and can still expose patients to risks . Therefore, it is important to look beyond drugs to treat patients with severe dementia symptoms, “says Watt.
In a comment published with the study, researchers emphasize the importance of non-drug-related treatments. For example, healthcare professionals can see if the dementia patient experiences pain, sleep insufficiency or other physical problems. Give the patient an activity that can give him or her purpose and make sure that their physical environment does not overestimate.
“We owe to older adults with dementia, which are some of the most vulnerable members of our society,” wrote Elia Abi-Jaoude, author of the commentary working on psychiatry at the University Health Network.