Neurological Drug Improperly Prescribed in Nursing Homes

Screen Shot 2017-12-15 at 2.43.26 PM.pngThe first rule in medicine is that doctors should do no harm. All drugs that are strong enough to make a difference have at least some risk of unwanted side effects, and physicians have a duty only to prescribe drugs for which the benefits outweigh the risks in a given situation. Everyone can agree that overmedicating patients simply to make them docile is wrong. Unfortunately, such practices happen in nursing homes more often than anyone wants to admit. Over-prescribing of medications in nursing homes is such a widespread form of elder abuse that Title 22, the section of California law that outlines the rights of nursing home patients, specifically condemns it.  Recent news reports have shown that a neurological drug called Nuedexta is frequently over-prescribed in nursing homes.

Nuedexta and its Indications

For people who really need Nuedexta, the drug can be a great help. The official indication of Nuedexta is as a treatment for pseudobulbar affect (PBA), a neurological condition that involves episodes of laughing or crying unrelated to an emotional stimulus that would cause them. PBA typically occurs as a symptom or result of other diseases and injuries that affect the brain. Many patients with PBA have suffered a stroke or traumatic brain injury, and it can also be associated with neurological diseases like Lou Gehrig’s disease or multiple sclerosis. While many PBA patients are elderly, the condition is not commonly associated with dementia. Unfortunately, though, many doctors prescribe Nuedexta to dementia patients in nursing homes, simply to manage the patients’ difficult behavior.

Nuedexta and Dementia Patients: Why is it a Problem?

Dementia can cause patients to become unpredictably confused, agitated, or even aggressive.  These behavioral symptoms of dementia can be very hard for caregivers to deal with; they are often among the factors that lead family members to decide that the patient can no longer live independently or be cared for at home. The rapid increase in Nuedexta prescriptions over the last five years has largely consisted of prescriptions for elderly patients in nursing homes, as a treatment for behavioral symptoms of dementia. The drug is an attractive choice because there are no other currently available drugs that do a better job of treating these symptoms.

The main negative side effect of Nuedexta is that it can affect balance. Therefore, patients who take Nuedexta are at greater risk of falling, and elderly patients in nursing homes already have a considerable fall risk. The other concern is that PBA is the only approved use for Nuedexta.  Avanir, the company that makes the drug, has taken steps for studying its safety and effectiveness as a treatment for dementia-related behavioral problems, but no proof has been published to the effect that Nuedexta does more good than harm for dementia patients.

Contact Case Barnett About Improper Prescribing Concerns

f you think that your relative is being given more medication than he or she needs in a nursing home, you should always voice your concerns. Contact Case Barnett in Costa Mesa, California if you think that over-medication has made your relative’s health worse.

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