Elderly people who use antipsychotic drugs have an increased risk of developing pneumonia. The first week after starting treatment, the chance of this was 4.5 times greater than for those in the control group. Researchers from University Medical Center (UMC) Utrecht described this in an article in last week’s issue of the Journal of the American Geriatrics Society. Around 40 percent of residents in nursing homes take antipsychotic drugs.
Together with colleagues, clinical geriatrician Dr. Rob van Marum analyzed a cohort of nearly 23,000 elderly people who had been prescribed antipsychotic drugs at least once. Of this group, 543 were found to have been admitted to hospital with pneumonia. The use of antipsychotic medication increased the risk of pneumonia by 60 percent compared to people in the cohort of the same age who had not taken such medication for a year. Pneumonia is an important cause of death in the elderly.
Doctors often prescribe antipsychotics for elderly people who have behavior problems associated with delirium or dementia. Because they can become hard to deal with, doctors are under a great deal of pressure to prescribe psychopharmaceutical drugs to sedate such patients. There is frequently also a lack of money and staff to provide the necessary nursing care. However, antipsychotic drugs do not help in many cases. Van Marum sees the prescribing of antipsychotics as a chemical solution to a problem that should be dealt with through social interventions.
“We prescribe medicines that are not only relatively ineffective, they lead to an increase in deaths,” van Marum says in summary. “For every ten to twenty patients who benefit from antipsychotics, the treatment results in one death. I would like doctors to take this more into consideration when they prescribe antipsychotic drugs.”
It is unclear exactly how these drugs cause pneumonia. Van Marum suspects that because they can cause slight drowsiness and possibly also muscle stiffness, swallowing can become difficult. Elderly people who take antipsychotics might choke more often and as a result develop pneumonia more frequently because food ends up in their lungs.
Van Marum conducted the research together with colleagues from the Tergooi Hospital in Hilversum and the Department of Pharmacoepidemiology and Pharmacotherapy at Utrecht University.