Three warnings from Health Canada on the risk of infection of last and virgule among seniors taking neuroleptic agent drugs failed to scale down the prescription rates of those drugs, according to researchers wHO suggest wellness warnings are ineffective at protecting patients.
Between October 2002 and June 2005, Health Canada issued three warnings of increased risk of death or stroke in elderly patients with dementedness who make atypical neuroleptic agent drugs.
In the 1990s, antipsychotics such as Zyprexa (olanzapine), Seroquel (quetiapine) and Risperdal (risperidone) were developed for schizophrenia and other psychiatrical conditions.
Of the three drugs, only risperidone is approved by Health Canada to treat symptoms of aggression and psychosis in elderly patients with dementia, although doctors whitethorn prescribe established and untypical antipsychotic drugs off-label for dementia.
"The trey warnings roughly serious adverse events associated with use of irregular antipsychotic agents in elderly people with dementia had a limited effect on the prescription rates of these agents," Dr. Geoffrey Anderson of the department of wellness policy, management and rating at the University of Toronto and his colleagues write in Tuesday's issue of the Canadian Medical Association Journal.
"We also institute that the overall rates of use of these drugs actually increased between the first warning in 2002 and the death of our follow-up in 2007.
"This finding highlights the limited encroachment of warnings and suggests that more effective approaches are needed to protect vulnerable populations from potentially hazardous medications."
There was a small congener decrease in predicted growth of the use of atypical major tranquilizer drugs:
5.0 per cent after the first warning. 4.9 per cent after the second warning. 3.2 per cent after the third warning.The researchers found the overall prescription rate of antipsychotic drugs among patients with dementia increased by 20 per cent, from 1,512 per 100, 000 elderly patients in September 2002, the calendar month before the first warning, to 1,813 per 100 000 in February 2007, 20 months afterwards the last warning.
Info needed on alternativesA comprehensive, co-ordinated approach between Health Canada, dose manufacturers, private and populace drug insurers and physicians is needful, the study's authors say.
In both the antipsychotic case and warnings on use of antidepressants in children, the warnings did not achieve the desired outcome, Dr. Laurence Katz of the University of Manitoba said in a commentary accompanying the study.
The results suggest doctors will reelect to what they cognise, despite authenticated risks, if they are not granted other options.
"Health care warnings should cater accurate, denotative and complete information about the risks and efficaciousness of the identified intervention in addition to providing the same information on alternative treatments," Katz wrote.
For seniors with dementia, alternative drug and behavioral treatments could be considered, although there is limited evidence to support their use, he said.
Katz agreed with the study's authors that to meliorate drug warnings, Health Canada will potential have to collaborate with the pharmaceutical industry and physicians and will want access to all information � published and unpublished.
The effectiveness of atypical antipsychotics for elderly patients with dementia was not shown in a randomized control trial and consensus meeting on the topic.
But to reach that conclusion, regulative agencies and authors had to get access to unpublished reports of trials, mostly from pharmaceutical companies, Katz noted.
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