Monday, January 12, 2009

Strongest drugs `double risk of death' for dementia sufferers

This is pretty disturbing stuff. Unwitting iatrogenic illness is bad enough but we seem to be looking at deliberate iatrogenic harm here

Alzheimer's patients who are given powerful drugs to calm them down are almost twice as likely to die prematurely as those not given the medication, a study has found. It is estimated that more than 100,000 elderly people are given antipsychotic drugs each year, despite warnings that they should not be given to people with dementia.

The latest research found that, after three years, fewer than a third of people on antipsychotics were alive compared with nearly two thirds given an inactive placebo, suggesting that up to 23,500 dementia patients are dying prematurely each year. The sedative drugs are normally given to people with serious mental illnesses, such as schizophrenia, and are not licensed to treat Alzheimer's. Campaigners say that the treatments are commonly prescribed unofficially as a "chemical cosh" to control agitation, delusions, sleep disturbance and aggression in difficult patients. Previous research has shown that the pills can accelerate mental decline and increase the risk of having a fatal stroke or developing symptoms of Parkinson's disease, prompting charities to call for their use to be curtailed.

In many nursing homes in Europe and North America, between 30 per cent and 60 per cent of residents with dementia are often prescribed antipsychotics for more than a year, the researchers write. The study, in the journal Lancet Neurology, is the first to look at the effect of giving the drugs to Alzheimer's patients over long periods. It involved 128 Alzheimer's patients in care homes, half of whom continued to take antipsychotic medications, such as risperidone or haloperi-dol, while the other half were switched to a placebo. The researchers found that the difference in survival rates between the two groups increased with time. After two years survival was 71 per cent for the placebo group and 46 per cent for the antipsychotics group. After three years 59 per cent of the placebo group were still alive compared with 30 per cent of those being treated with antipsychotics.

Clive Ballard, who led the study at King's College London, said that the research presented serious safety concerns. He added: "It is essential to reduce the widespread long-term prescription of these drugs by using more nondrug treatments, such as psychological therapies, and more research is urgently needed to establish more effective and safer drug treatments."

The National Institute for Health and Clinical Excellence (NICE), the medicines watchdog, says that antipsychotic drugs should be used only in severe cases for short periods. Evidence suggests, however, that they are commonly prescribed for Alzheimer's patients for between one and two years in Britain. A report from the all-party parliamentary group on dementia stated last year that almost three quarters of those taking the drugs were given them inappropriately - at a cost of more than 60 million a year.

The study was funded by the Alzheimer's Research Trust. Its chief executive, Rebecca Wood, said: "The findings are a real wake-up call." Phil Hope, the Care Services Minister, said: "The inappropriate administration of medication is entirely unacceptable and this will be examined in the National Dementia Strategy which is due to be published shortly."


New nasal spray that could stop the flu virus from laying you low

A spray that might stop flu in its tracks is being developed by scientists. It would fight off all strains of the virus, including those behind bird flu and winter flu. Researchers at St Andrews University are developing a nasal spray that would stop people from being infected when the bug is circulating.

Flu kills up to 22,000 Britons a year. A pandemic of the human form of bird flu - which many believe is inevitable - could claim 700,000 lives in the UK alone. The current flu jab protects only three-quarters of those vaccinated and needs to be reformulated each year to keep on top of changes in the virus's appearance.

Anti-flu drugs that attack the bug are available. But they are mainly used to treat the infection and the virus can mutate to become resistant to treatment. The one-size-fits-all spray works in a different way. Instead of attacking the bug directly, it latches on to the cells it infects, stopping the virus from taking hold. Usually, the flu virus enters the cells of our nose, throat and lungs by locking on to a sugar sticking out from their surface. Once inside, the virus rapidly multiplies, before bursting its way out, killing the cells in the process.

Scientists at St Andrews have created a range of proteins that bind to the sugar, stopping the flu bug in its tracks. Targeting the sugar rather than the virus itself means the bug is unlikely to become resistant to the drug, say the researchers. And as all strains of flu use the same sugar - sialic acid - when infecting cells, the protein-based drug should ward off all types of the disease.

Following promising initial lab tests, the researchers have received funding to move on to animal tests. If these prove successful, the technology could be sold to a drugs firm and a nasal spray could be on the market in less than ten years.

Researcher Professor Garry Taylor-said: 'There are two drugs currently used for the treatment of influenza but the virus has become resistant to one of these. We think we can mask the sugars long enough for the virus not to be able to get a foothold. 'We envisage it would be given as an aerosol, a bit like an asthma inhaler because you want to get it into the respiratory tract quickly. But there is a long way to go.'

Professor Malcolm McCrae, a Warwick University virologist, advised caution. He said: 'I would ask them how long this is going to work for and how much people are going to have to take.' But John Oxford, Britain's leading flu expert, said the spray could potentially stop people from catching flu all together. Professor Oxford, of Queen Mary's School of Medicine in London, said: 'If you could cover all the sugars like a blanket and they remain covered, it would stop you from catching flu.'


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