Doctors in nursing homes prescribe antipsychotic drugs with the same lack of thought that the service staff employs to place the order for tomorrow's newspapers. Most of the elderly residents have dementia, or so the doctors conclude, and so an antipsychotic, such as quetiapine, keeps them quiet and quells their agitation.
This careless and lazy prescribing is little short of a criminal act. Doctors should (and do) know that antipsychotics are at best only mildly effective, but come with an enormous range of possible adverse reactions, including an increased risk of stroke. In short, the risks outweigh the benefits.
This point has been forcibly driven home by a new study that discovered that quetiapine in particular 'significantly' contributes to cognitive decline. So here's the vicious circle: doctor suspects the patient of dementia, so the doctor prescribes quetiapine. Patient displays more convincing symptoms of dementia. Ergo, original diagnosis was right, and the treatment protocol vindicated.
The study concludes that "quetiapine and rivastigine (another antipsychotic) seemed of no benefit in patients with dementia and agitation in institutional care, and quetiapine was associated with greater cognitive decline than placebo. Our results suggest that quetiapine should not be used in people with dementia".
This is a damning conclusion (certainly by the standards of medical trials), but it's one we fear will be disregarded.