Exclusive - PCTs ignore advice on antipsychotics

PCT inaction leaves dementia patients on drugs despite safety concerns.

GPs have no alternative to prescribing antipsychotics in dementia
GPs have no alternative to prescribing antipsychotics in dementia

Over half of PCTs in England are failing to commission services to reduce antipsychotic prescribing among dementia patients, despite well-known safety risks, GP newspaper can reveal.

Results of the GP newspaper investigation on dementia

The findings increase pressure on the DoH to release its antipsychotics review, originally expected in spring.

Responses from 62 PCTs to a request for information by GP newspaper show 57 per cent are failing to offer services to help GPs cut prescribing of the drugs risperidone and olanzapine.

GPs have previously warned they are forced to prescribe the drugs, which can triple the risk of stroke and double the risk of death, because of a lack of alternative services to refer to.

The responses received also show that half of PCTs do not carry out audits recommended by NICE to find those dementia patients who are suitable for treatment with acetyl-cholinesterase inhibitors, such as donepezil, rivastigmine and galantamine.

Alzheimer's Society chief executive Neil Hunt said: 'It is a sad day when prescribing of antipsychotics is unacceptably high and prescriptions of cholinesterase inhibitors are among the lowest in Europe.

'We must develop health and social care services that can respond to the challenge of dementia.'

North Shields GP, Dr Dave Tomson, who has an interest in mental health, said: 'Most people now know antipsychotic prescribing is not desirable, but it still happens because of a lack of alternatives.

'PCTs could incentivise GPs to take regular audits and reviews of antipsychotic prescribing.'

He called for better teamwork between health professionals and nursing homes.

Professor Irwin Nazareth, an expert in primary care mental health at University College London, added: 'PCTs need to assess the extent of the problem, then assist GPs with a programme of stopping use of these drugs in this group of patients and finally offering alternative treatment options.'

A DoH spokeswoman said the antipsychotic review would be published in November. Only 'severely distressed' dementia patients or those putting themselves or others at risk should receive the drugs, she said.

PCT failures

  • 57 per cent of PCTs are failing to offer services to cut antipsychotic prescribing
  • 52 per cent of PCTs have not carried out an audit to find patients suitable for cholinesterase inhibitors

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