The use of antipsychotic medications in the treatment of dementia has significantly declined since 2003, according to a new study in the Archives of General Psychiatry.
Researchers from the University of Michigan and VA Ann Arbor Healthcare System found the use of these meds in treating dementia decreased even before a "black box" warning from the Food and Drug Administration in 2005—the strongest type of warning issued by the FDA. This shows that emerging evidence of the medications' increased risk of diabetes and stroke have been taken seriously, researchers said.
Prescriptions of the antipsychotics dropped off more steeply after the black box warning, which shows that it too had an impact, the researchers concluded.
“If you look at the history of black box warnings, sometimes they have an effect and sometimes they do not,” researchers said. “When the warning was issued about children taking antidepressants, we saw a big drop in use, but in other cases there wasn't much change. In this case, providers appeared to be responsive.”
The analysis drew from data on more than 250,000 patients from national Veterans Affairs registries maintained in Ann Arbor.
While the number of dementia cases among VA patients 65 and older more than tripled from 30,000 in 1999 to 100,000 in 2007 as World War II and Korean War veterans aged, the study found the use of antipsychotic medications declined. Prescriptions fell from about 18% of patients to 12%.
The study authors do not pinpoint a single reason for the decline during the period before the warning, but observed that doctors and media outlets were starting to take note of fatal risks associated with the class of medications.