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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by med_empowered on May 1, 2006, at 19:38:43
http://www.healthsentinel.com/org_news.php?event=org_news_print_list_item&id=047
check it out.
Posted by linkadge on May 1, 2006, at 20:13:44
In reply to Drugging up old people with Atypicals, posted by med_empowered on May 1, 2006, at 19:38:43
Its discusting. Especially since a lot of old people are going to show deficiancies in dopaminergically mediated functions due perhaps to age related receptor decline.
Way to make old people's lives dull.
Linkadge
Posted by med_empowered on May 1, 2006, at 20:50:22
In reply to Re: Drugging up old people with Atypicals, posted by linkadge on May 1, 2006, at 20:13:44
yeah...with the advent of the atypicals, I kind of wonder if we're returning to the "good old days" (1950s-1970s, roughly) of overusing antipsychotics--basiclaly, giving them to anybody and everybody to shut them up.
Back in the day, Thorazine was called "zombie juice" in Juvenile facilities b/c it was administered so often. Now prisoners call Seroquels "Quells". Old people used to get doped up on thioridazine, haloperidol, etc.--now its Zyprexa, Risperdal, etc.
"Hyperkinetic" children were once given Thorazine in place of (or, strangely, sometimes in addition to) Ritalin. Now we're seeing ADHD kids being given atypicals...sometimes alongside stimulants.
Personally, I find this all very disturbing. Even without tardive dyskinesia, antipsychotics have the potential to dullen and deaden a person's existence. Why is this "therapy" ? And why do shrinks feel so comfortable doing this to *SO MANY* people with different "issues" ?
Posted by linkadge on May 1, 2006, at 21:02:07
In reply to Re: Drugging up old people with Atypicals, posted by med_empowered on May 1, 2006, at 20:50:22
I don't understand why they can't separate the drug to create a serotonin selective antagonist.
5-ht2 blockers can help with anxiety agitation, and insomnia without causeing all the dysphoria.
My mother was given risperdal for sleep. 2mg is making her a zombie. She sleeps almost all day.
I mean we should treat old people with the most respect. They should be getting our fastest acting and most surefire mood brighteners to make their last days as good as any other.
Linkadge
Posted by med_empowered on May 1, 2006, at 21:37:37
In reply to Re: Drugging up old people with Atypicals, posted by linkadge on May 1, 2006, at 21:02:07
yeah...I personally don't see why we aren't using benzos in old folks. I mean, yes, high-doses and the wrong benzos will cause problems like falls and resulting fractures, but if its done carefully...you can improve their lives, and the lives of those around them. Seems like low-dose Klonopin/Tranxene could be highly effective w/o causing problems. It also seems like altering the environment would make old people happier and less in need of psychotropics. But then...shrinks would be out of a job.
Posted by Phillipa on May 1, 2006, at 21:40:00
In reply to Re: Drugging up old people with Atypicals, posted by linkadge on May 1, 2006, at 21:02:07
Simply put it means less staff less cost to the nursing homes if the patients are asleep. Plus when I was a Director of Nursing in a nursing home around l2 years ago their vest restraints so they don't fall out of wheel chairs were being banned basically. Against their rights so they said. They only kept them safe , could go outside, visit with other resident, do crafts, ets. Not fair. I already told my husband if that day comes I will take matters into my own hands. Love Phillipa
Posted by saturn on May 1, 2006, at 21:43:24
In reply to Re: Drugging up old people with Atypicals, posted by med_empowered on May 1, 2006, at 21:37:37
> yeah...I personally don't see why we aren't using benzos in old folks. I mean, yes, high-doses and the wrong benzos will cause problems like falls and resulting fractures, but if its done carefully...you can improve their lives, and the lives of those around them. Seems like low-dose Klonopin/Tranxene could be highly effective w/o causing problems.
Couldn't agree more.
Posted by Caedmon on May 2, 2006, at 11:32:52
In reply to Re: Drugging up old people with Atypicals » med_empowered, posted by saturn on May 1, 2006, at 21:43:24
Well, if you're in a nursing home, there is a good chance you have moderate-severe dementia. I would assume that many of the APs are to control the psychotic symptoms of that. The question is one of whether or not it's effective, which I don't know.
The problem is much wider than just one of inappropriate AP prescription. Nursing facilities in general can be a haven for poor treatment.
- C
Posted by ed_uk on May 2, 2006, at 13:47:28
In reply to Re: Drugging up old people with Atypicals, posted by Caedmon on May 2, 2006, at 11:32:52
Inappropriate prescribing of APs is a definite concern. Atypical APs produce a large increase in *mortality* in elderly patients with dementia. They have, as a result, received a black-box warning from the FDA.
Risperidone (Risperdal), usually at a dose of 0.5mg bid or similar, can be an effective treatment for paranoia, delusions and hallucinations in patients with dementia.
Ed
Posted by linkadge on May 2, 2006, at 15:40:28
In reply to Re: Drugging up old people with Atypicals, posted by ed_uk on May 2, 2006, at 13:47:28
How about opiates. Nothing would calm old people down better, and make them more positive and happy. Opiates are the ultimate anti-agitation drugs. It would help their pain, sleep etc.
Who cares if you get old people addicted to opiates. They're old. It doesn't matter if they get addicted.
Linkadge
Posted by ed_uk on May 2, 2006, at 15:46:25
In reply to Re: Drugging up old people with Atypicals, posted by linkadge on May 2, 2006, at 15:40:28
Hi Link
Opioids are useful, but side effects are relatively frequent, especially in the elderly.
Ed
Posted by Caedmon on May 2, 2006, at 16:38:33
In reply to Re: Drugging up old people with Atypicals, posted by ed_uk on May 2, 2006, at 13:47:28
> Inappropriate prescribing of APs is a definite concern. Atypical APs produce a large increase in *mortality* in elderly patients with dementia. They have, as a result, received a black-box warning from the FDA.
>
> Risperidone (Risperdal), usually at a dose of 0.5mg bid or similar, can be an effective treatment for paranoia, delusions and hallucinations in patients with dementia.>>Interesting!
I wonder how it gets to be this way, with so many neuroleptics prescribed in the elderly. Are the doctors just ignorant? Careless? It's sad. :-( Of course I am sure that there are many nursing facilities with good practices, and *judicious* use of neuroleptics (whatever that might constitute).
- C
Posted by ed_uk on May 2, 2006, at 17:17:19
In reply to Re: Drugging up old people with Atypicals » ed_uk, posted by Caedmon on May 2, 2006, at 16:38:33
Hi C
Here is the black box warning for atypicals, seen here under Abilify.......
http://www.rxlist.com/cgi/generic/abilify.htm
Ed
Posted by ed_uk on May 2, 2006, at 17:19:10
In reply to Re: Drugging up old people with Atypicals » ed_uk, posted by Caedmon on May 2, 2006, at 16:38:33
One wonders how much atypicals increase the mortality of younger patients. Obesity, diabetes, thromboembolism............. not good for the health!
Ed
Posted by linkadge on May 2, 2006, at 18:04:13
In reply to Re: Drugging up old people with Atypicals » Caedmon, posted by ed_uk on May 2, 2006, at 17:19:10
I just know I'd rather go out on opiates than on neuolepteics.
Linkadge
Posted by Phillipa on May 2, 2006, at 18:39:03
In reply to Re: Drugging up old people with Atypicals » Caedmon, posted by ed_uk on May 2, 2006, at 17:19:10
Ed don't tell Chris. Love PJ O
Posted by ed_uk on May 3, 2006, at 10:37:08
In reply to Re: Drugging up old people with Atypicals » ed_uk, posted by linkadge on May 2, 2006, at 18:04:13
Hi Link
Yep, me too, I've been on APs, they were just awful. I want to make sure that I will never be given an AP when I'm old. Give me the morphine.
Ed
This is the end of the thread.
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