As the studies of drug therapy for behavioral expressions in dementia continue to appear, a groundswell of critics has also followed. As I continue to speak out, so do these allies.
Sister Imelda Maurer from San Francisco wrote me last week, dismayed about the recent “aripiprazole for agitation” study in JAMDA. Next, Carter Williams wrote me about a new study in Annals of Long Term Care on “nursing home violence”, with the comment: “They need your book!”
(For the record, all of these drug studies make a distressed symptom slightly quieter than placebo, and call it a “positive” outcome. The problem is that this doesn’t rule out sedation and it doesn’t show increased contentment, engagement or growth. Worse still, it views these expressions purely as a “problem” to be “managed”, without asking what basic needs are not being met. Plus they double your mortality.)
Let me tell you what scares me even more:
I’m scared about the way these drugs are being marketed to younger people for depression and other illnesses. “Is your antidepressant not quite doing the job? Take Abilify!”
The practice of using anti-psychotics for life-threatening depression has been expanded to using them to “amplify” therapy less severe cases.
I have a friend whose daughter was diagnosed with “oppositional disorder” and given Abilify. She has had a lot of trauma — about a dozen operations, due to a congenital cranio-facial problem. She is only 10 years old.
We have no idea what the long range effect of these drugs will be.