I advocate against the inappropriate use of antipsychotics in treating people who live with dementia because I have seen first hand the devastating impact these drugs may have. Sadly, many dementia care partners are forced to turn to medication out of desperation. In order to be be able to make an informed decision, it’s important to know the side effects of the medication in question.
Antipsychotics risperidone (Risperdal) and quetiapine (Seroquel) carry black box warnings in the US because, like other antipsychotics, they increase the risk of mortality in elderly patients with dementia. Furthermore, recent research shows these medications are largely ineffective in treating behavioural expressions in people who live with dementia. Not surprisingly, geriatricians worldwide recommend against their use, saying they should only be given as a last resort after all non-pharmacological strategies have been tried. Unfortunately, too many people who live with dementia are still inappropriately prescribed these drugs, just as my mother was.
Risperidone (Risperdal) is an atypical antipsychotic drug that is meant to be used to treat schizophrenia and symptoms of bipolar disorder. In Canada, it is “restricted to the short-term symptomatic management of aggression or psychotic symptoms in patients with severe dementia of the Alzheimer type [who are]unresponsive to non-pharmacological approaches and when there is a risk of harm to self or others.” (Bolding mine.) More information on Canada’s position here.
The United States Federal Drug Administration includes this “black box warning” on its Risperdal information sheet:
In November 2013 pharmaceutical giant Johnson and Johnson was fined $2.2 billion by the United States Department of Justice for illegally marketing three drugs one of which was Risperdal (for use in people with dementia).
Risperdal may produce side effects similar to the very conditions it is meant to alleviate in people who live with dementia.
Here are 40 of the potential side effects of Risperdal (there are more here):
- aggressive behaviour
- changes in vision, including blurred vision
- difficulty concentrating
- difficulty speaking or swallowing
- inability to move the eyes
- increase in amount of urine
- loss of balance control
- mask-like face
- memory problems
- muscle spasms of the face, neck, and back
- problems with urination
- restlessness or need to keep moving (severe)
- shuffling walk
- skin rash or itching
- stiffness or weakness of the arms or legs
- tic-like or twitching movements
- trembling and shaking of the fingers and hands
- trouble sleeping
- twisting body movements
- back pain
- chest pain
- speech or vision problems
- sudden weakness or numbness in the face, arms, or legs
- dry mouth
- increased dream activity
- increased length of sleep
- sleepiness or unusual drowsiness
- sore throat
- stuffy or runny nose
- unusual tiredness or weakness
- weight gain
Giving risperidone (Risperdal) to people who live with dementia and who may be unable to report the side effects they are experiencing is cruel and in many cases completely unnecessary. Read more about why drugs like Risperdal are still inappropriately prescribed to elderly people who live with dementia.