Off-label drugs can worsen dementia

Q: My mom has been diagnosed with dementia, and her doctor wants to put her on an antipsychotic medicine. That seems weird, since it isn’t approved for dementia (I looked it up). I know some off-label use of meds is acceptable, but I said no to this one. Was I wrong?

Jean P., Davenport, Iowa

A: We are sorry that your mom — and you — have to deal with dementia, and we cannot know if, in her particular case, there are symptoms or a medical history that makes that particular prescription appropriate. But we do know that, overall, many dementia patients are prescribed a whole pharmacy of medications that are neither approved for nor necessarily good for someone with that condition.

A new study out of Michigan Medicine found that in a group of 737,839 people with dementia, almost 75% had been prescribed medicines that target the brain and nervous system but are not designed to manage dementia. Some of the medications have even been found to make cognition worse, not better.

The off-label medications that the researchers noted were being prescribed included antidepressants, opioid painkillers, an epilepsy drug, anxiety medications and antipsychotic drugs. In addition to increasing risks for falls and drug dependence, the researchers point out that these meds can have side effects that may seem dementia-related.

Unfortunately, the patient can’t explain clearly how the medication is affecting him/her and that can lead to the additional prescription of even more unnecessary medication when the smart move would be to adjust or stop taking the drug that is causing the side effect.

We suggest you talk with your mom’s doctor and ask:

— What specifically made that prescription a good choice?

— What are the potential side effects?

— Are there are behavioral interventions that can ease symptoms that need addressing.

— What approved medications for dementia might be worth trying?

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Medical Officer at the Cleveland Clinic Wellness Institute. Submit your health questions at www.doctoroz.com.