Belgium: One in three people in care homes given antipsychotic drugs

Brussels, Belgium: One out of three individuals in residential care homes more than the age of 75 receives an antipsychotic against hallucinations and delusions, including the majority of the patients with dementia. The medication is often used incorrectly or without any scientific basis.

Following several suspicious casualties in a residential care home in the municipality of Oostrozebeke in the West Flanders province in the previous month.

Along with this, one in three over-75s living in residential care homes receives such medicines, as per the figures collected by the various health insurance funds.

These include the well-known antipsychotic Haldol, but also drugs such as Risperdal as well as Quetiapine, which were initially used in psychiatry or delusions, geriatrician Mirko Petrovic (University of Ghent) shared the information.

He highlighted, “But in practice, they are also often used for people with dementia when they show behavioural disorders,” He explained that this could be helpful for some of them if the disease causes them to hallucinate or become physically aggressive.

“For the milder symptoms of this disease, there is insufficient evidence that antipsychotics work.”

In addition, Petrovic mentioned in the statement that the medication is sometimes prescribed for symptoms that are not intended. “Currently, the use in these patients is too high.”

Medication against psychosis is of no use against other common symptoms of dementia patients, including wandering behaviour, running away and shouting.

“There is no scientific evidence for that. With such difficult-to-manage behaviour, we must first look at solutions without drugs.”

However, of all over-75s in residential care homes, about 10 percent to 15 percent really need such an antipsychotic, explained Jan De Lepeleire, emeritus Professor of family medicine at KU Leuven.

“One is three is a lot. And its use should not be for the long term, but for a short, defined period.”

The figures from the Intermutual Agency show that for 41 percent of older adults receiving the medication, treatment lasted longer than six months, which leads to more serious side effects.

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