Physicians are attempting to decrease the use of antipsychotics in senior dementia patients however the typical alternative trazadone dosage has similar detrimental side effects.
According to new research now published in the Canadian Medical Association Journal, although physicians are attempting to reduce the use of antipsychotics in dementia patients (typically seniors), they need to be wary that the frequently used trazadone dosage is associated with the similar risk of falls and major fractures as atypical antipsychotics.
Trazadone dosage in dementia patients
In Canada, the number of dementia patients are increasing by 7%, but it approaches almost 25% in people older than age 85. In long-term care facilities, 62% of residents have dementia, and many demonstrate aggressive behaviour. Although evidence is limited on efficacy, the use of antipsychotics and the level of trazadone dosage, an antidepressant also used for sleep issues, are commonly prescribed to dementia patients.
Dr. Jennifer Watt, St. Michael’s Hospital, Canada, explains: “As clinicians move to decrease antipsychotic use, we should not consider trazadone as a uniformly safer alternative to atypical antipsychotics, because trazadone use was associated with a comparable risk of falls and major osteoporotic fractures to atypical antipsychotics – drugs associated with these adverse outcomes in our patient population.”
The use of antipsychotics vs trazadone dosage
The researchers looked at data on 6,588 seniors newly dispensed trazadone dosage and 2,875 newly dispensed an atypical antipsychotic. They found that patients dispensed trazadone had a rate of falls and major fractures, including hip fractures, similar to that of the group receiving atypical antipsychotics. However, trazadone was associated with a lower risk of death in these patients.
Dr. Elia Abi-Jaoude, The Hospital for Sick Children (SickKids) and University Health Network, Canada, highlights how the information can be used to inform patients and caregivers about the benefits and risks of different treatment options. He concludes: “Watt and colleagues also underscore the importance of prioritizing nonpharmacological approaches for the management of behavioural and psychological symptoms of dementia.”
