Recent research has highlighted new issues with medication and harms. In April 2018 Professor Fox reported in the British Medical Journal (BMJ 2018;361:k1315)
results of a study with risk of developing dementia and use of antidepressants, medicines for bladder incontinence and Parkinson’s medication. The research looked back over 20 years, analysed primary care records in 100,000 patients and reported a 20% increased risk of developing dementia with commonly used medications; for example, antidepressants prescribed to 1 million people. This study is the first to specifically link certain medication with anticholinergic effects to dementia. NICE Dementia 2018 has highlighted the risks and prescribers are being advised to be careful with use of these medications and to discuss and document discussions with patients.
In a second recent related study Professor Fox has been investigating the harms of commonly prescribed sleeping tablets in people with dementia - so called Z drugs (for example Zipiclone and zolpidem). Investigating patient records has found a risk of serious fractures of the hip in these patients with a 40% increase. These fractures have a 30% mortality rate. Professor Fox has concluded that People living with dementia should only be prescribed a hypnotic if the benefits clearly outweigh the risks, and any such prescription should be regularly reviewed. Fractures in people with dementia can have a devastating impact, including loss of mobility, increased dependency, and death. We desperately need better alternatives to the drugs currently being prescribed for sleep problems and other non-cognitive symptoms of dementia.
A link to a summary of Professor Fox's findings can be found here.