A new survey of GP prescribing has found that despite a 2004 safety warning, powerful psychiatric drugs that can cause strokes are still being prescribed for dementia patients.

72% of the 335 GPs surveyed replied that they had prescribed risperidone for dementia patients in the past four years, while 53% had written up olanzapine. Some of the GPs who responded to this survey reported that they prescribed antipsychotic drugs to 90% of their dementia patients.

A mere 15 doctors responded that they would ‘never’ prescribe anti-psychotic medication for patients with dementia.

The study, carried out by Medix for BBC Radio 4’s File On 4 programme, found that more than half of these GPs routinely prescribed risperidone and olanzapine. In 2004, the Committee on Safety of Medicines (which in 2005 merged into the Committee on Human Medicines) issued a warning that these drugs can cause strokes in elderly patients with dementia.

Risperidone and olanzapine are usually prescribed for psychotic conditions such as schizophrenia. The Committee on Safety of Medicines stated that it had found evidence that the drugs “indicate an increased risk of stroke which particularly applies when these drugs are used by elderly people with dementia. Risperidone or olanzapine should not be used for the treatment of behavioural symptoms of dementia."

Danger of harm
Dr Lewis Morrison, chair of the community care committee of the British Medical Association, told File On Four of the prescribing trend uncovered, "I think it happens because situations arise where the patient is physically very disturbed and is at risk of doing violence to themselves or others."

Call for disciplinary action
Dr Tim Kendall, Joint Director of the National Collaborating Centre for Mental Health of NICE, suggested to the programme that the findings represented "awful indictment", and suggested that GPs prescribing antipsychotics to 90% of their dementia patients “should be disciplined. A doctor prescribing for 90% of their patients an anti-psychotic when there is enough guidance to say ‘don't’ - it's unacceptable."