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GPs under 'pressure' to issue neuroleptics, claims professor

GP leader Professor Steve Field has claimed GPs are under great pressure from nursing home staff to prescribe neuroleptics for agitated patients.

Following publication of new data in The Lancet showing increased mortality in Alzheimer’s disease patients receiving neuroleptic treatments, Royal College of General Practitioners chairman Professor Field said the drugs could be extremely dangerous.

They should be prescribed only when absolutely necessary and only after a thorough assessment, and even then patients should only be given the treatment for a very short time. The treatment should also be reviewed regularly.

“Doctors can come under great pressure from staff in nursing and rest homes to prescribe these drugs to agitated patients,” he said.

“But we know doctors across the country are being vigilant and doing everything they can to avoid prescribing these drugs except as a last resort.”

The new mortality results come from long-term follow up of the DART-AD study of the effect of neuroleptics on cognitive decline and neuropsychiatric symptoms in patients with Alzheimer’s disease living in care facilities.

Survival over 12 months was 70 per cent in the treated group compared with 77 per cent in the placebo group. The difference between the two groups was more pronounced over time, with survival at 46 per cent and 71 per cent respectively at 24 months, and 30 per cent and 59 per cent at 36 months.

The authors said the results highlighted the need for less harmful long-term treatments for neuropsychiatric symptoms in these patients.

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