Needless treatments: antipsychotic drugs are rarely effective in ‘calming’ dementia patients

Many trials have examined the effectiveness of antipsychotics to treat agitation in people with dementia. These studies show they only offer benefit to about 20% of people with these symptoms and appear to offer no benefit for other responsive behaviours such as wandering, crying out or anxiety.

 No Benefit Seen From Antipsychotics Used in Delirious Hospital Patients

Hospitals have given antipsychotics to delirious patients for decades, but a new study found that two of the drugs produced little benefit.

 The Psychiatric 'Wonder Drug' That Almost No One Is Using

Clozapine could save the lives of suicidal schizophrenic people who aren't responding to other treatments. So why are so few doctors using it?

How this antipsychotic became America’s best-selling drug

Perhaps most worrisome is that America’s best-selling drug is not well understood. A Daily Beast analysis of the literature around Abilify concluded that while the drug is considered effective, the mechanics of how it works remain unclear. That should give pause to its consumers, especially since its gatekeepers don’t seem to mind.

Antipsychotic Drug Side Effects

Common brand name Antipsychotics include Abilify, Clozaril, Geodon, Invega, Risperdal, Seroquel, Zyprexa, Fanapt.

Antipsychotic Drugs, Their Harmful Effects, and the Limits of Tort Reform

Although many millions of people are seriously harmed each year by the so-called antipsychotic drugs, relatively few victims are able to bring malpractice or product liability suits. Since the drugs work by producing a chemical lobotomy, patients who remain medicated are too apathetic to complain or even to recognize their abnormal movements.

Are doctors following best practice when prescribing antipsychotic meds to kids?

There’s been a lot of attention in the media about the number of children taking antipsychotic and other psychiatric medications. The assumption behind most of these stories is that these drugs are being overprescribed, and given to children with minor behavioral issues.

At last, a promising alternative to antipsychotics for schizophrenia

For many, the side-effects of antipsychotics are worse than the symptoms they're meant to treat. No wonder some people with schizophrenia refuse to take them.

Do We Overprescribe Antipsychotic Drugs for Children?

I do understand that there are some children who will need to be put on medication, but it does appear that other options seem more out of reach for families who are on assistance or for children in foster care.

Explainer: what is Seroquel and should you take it for insomnia?

Doctors prescribe quetiapine off-label for various conditions, including anxiety, autism, post-traumatic stress disorder, substance abuse and obsessive compulsive disorder. It is also increasingly prescribed off-label for insomnia, usually at lower doses of 100mg or less a day. But the evidence so far suggests the risks of prescribing quetiapine off-label outweigh any benefits.

Long-term Antipsychotics – making sense of the evidence

There are times when the use of antipsychotic drugs seems to produce just enough suppression that people can put aside their psychotic preoccupations, and re-establish a connection with the outside world.

Robert Whitaker: The Case Against Antipsychotics

Over the past 35 years, psychiatry—as an institution—has remade our society. This is the medical specialty that defines what is normal and not normal. This is the medical specialty that tells us when we should take medications that will affect how we respond to the world. And this is the profession that determines whether such medications are good for our children. Given that influence, we as a society naturally have reason to want to know how the leaders in the profession think, and thus how they come to their conclusions about the merits of their drugs.

Setting the Record Straight on Antipsychotics

In the 1990s, a new generation of antipsychotics was introduced that initially showed great promise. The new meds were no more effective than the old. But they were much better tolerated because they usually didn’t cause the muscle rigidity or agitated restlessness that had made patients feel so uncomfortable and look so strange .

Still in a Crib, Yet Being Given Antipsychotics

Most experts suspected that the trend of medicating younger and younger children for suspected psychiatric disorders was trickling down to very young children.

Story of antipsychotics is one of myth and misrepresentation

They now rival statins (used to lower cholesterol) and antidepressants in terms of the revenue they bring in. And in England, their use has increased by two thirds over the last few years. The most lucrative market is for treating the newly fashionable diagnosis of bipolar disorder.

The Overuse Of Antipsychotics In Dementia Care

When these medications are prescribed for the behavioral symptoms in dementia patients, they are being used as “off label.”

Use Of Antipsychotic Medication Linked To Reduced Rate Of Violent Crime

The medications are highly effective when patients are complaint, but whether they can also lead to a reduction in violent crime is a question of many mental health professionals, families, but also those in law enforcement.

What It’s Like to Be Forced to Take Anti-Psychotic Drugs

After involuntary mental health treatment many patients feel afraid to seek more help. A constitutional challenge could change the way patients consent to treatment in British Columbia.

When Older Drugs are Better Drugs

Pharmaceutical firms want doctors to use the newest medications on the market—but that’s not always the right choice.

Why Pharma Wants to Put Sensors in This Blockbuster Drug

Getting people to take their pills is hard, especially with mental illnesses like schizophrenia and bipolar disorder. But to use the language of techno-optimism: “There’s an app for that!”

A Fumbling, Mumbling Mess!

This patient has developed a classic anticholinergic toxidrome. The hallmark of this toxidrome is an agitated delirium accompanied by variable signs of central and peripheral muscarinic (acetylcholine) receptor blockade.

Antipsychotic Medications

First-generation antipsychotics are dopamine receptor antagonists (DRA) and are known as typical antipsychotics. They include phenothiazines (trifluoperazine, perphenazine, prochlorperazine, acetophenazine, triflupromazine, mesoridazine), butyrophenones (haloperidol), thioxanthenes (thiothixene, chlorprothixene), dibenzoxazepines (loxapine), dihydroindoles (molindone), and diphenylbutylpiperidines (pimozide). Second-generation antipsychotics are serotonin-dopamine antagonists and are also known as atypical antipsychotics... They are risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, asenapine, lurasidone, iloperidone, cariprazine, brexpiprazole, and clozapine.

Hidden data show that antipsychotic drugs are less effective than advertised

The two other studies involved Geodon (ziprasidone). One study found Geodon to be no more effective than a placebo. The second found that while Geodon was more effective than a placebo, it was less effective than an older — and much less expensive — drug, Haldol (haloperidol).

Pharmacology of antipsychotics

The distinction between "typical" and "atypical" antipsychotics is an entirely artificial line that was drawn for marketing purposes when clozapine became available on the market in the early 1970s. Less extrapyramidal side effects, they said. Contemporary reviews of this distinction have been unable to confirm the existence of this sharp distinction. Some "typical" antipsychotic agents have very few extrapyramidal side effects (for example, perazine), and some of the novel atypical agents (eg. risperidone) have plenty of them, making it an ineffective method of discriminating between agents.

Phenothiazines and butyrophenones

Phenothiazines and butyrophenones are the antipsychotic (neuroleptic) agents. Commonly used agents are chlorpromazine, prochlorperazine, droperidol and haloperidol. Other unfamiliar agents include fluphenazine, Pericyazine, Pipothiazine and Trifluoperazine. If you think how you use these drugs in an aggressive patient you will understand their effects in overdose for a spectrum of CNS depression, orthostatic hypotension, anticholinergic effects and rarely dystonia.