Concern overseas about the high use of antipsychotic
medicines in the elderly has prompted government drug buying
agency Pharmac and the College of Psychiatrists to release
new usage guidelines here.
Concern has been expressed in the United States and Britain
that high usage of antipsychotics in the elderly carries
potential health risks including possible increased risk of
stroke and higher death rates.
While it was unclear whether there was significant
over-prescribing of antipsychotics in New Zealand, Pharmac's
prescribing data showed there was comparatively high use of
antipsychotics among older people.
In 2006/07 about 20 percent of older-generation
antipsychotics, 24 percent of risperidone and 17 percent of
quetiapine prescriptions were for people aged between 80 and
90.
About 35,000 prescriptions were recorded for people aged
80-90.
"When this data is coupled with growing international concern
about the use of antipsychotics in the elderly, we think it's
the right time to develop guidance on how best to use these
medicines," Pharmac's medical director Peter Moodie said.
"This isn't about telling doctors how to do their jobs, it's
about ensuring these medicines are used well and risks to
patients are minimised."
Dr Moodie said the guidance encouraged evidence-based
treatment of elderly people in residential care with
psychological and behavioural symptoms of mental disorders.
Dementia was the most common psychiatric disorder in that
sector of people.
Royal College of Psychiatrists New Zealand spokesman Matthew
Croucher said the college had fully supported the Pharmac
initiative.
"Although there is little evidence of systematic harms being
caused in New Zealand, there is plenty of room for improved
prescribing and review of antipsychotic medicines and for
improved overall management of challenging mental health
problems in residential care," Dr Croucher said.
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