Please Look After Dad

Panorama: Please Look After Dad, BBC One 8.30pm, Monday 3 December

Panorama reporter Vivian White presents the evidence that in the long-term, treatment of dementia patients with anti-psychotic drugs has no benefit and can shorten patients' lives.

Eric Hollingworth died last week. He was 81-years-old and in a care home.

He was diagnosed with Alzheimer's four years ago and was being treated with anti-psychotic drugs.

He would sit slumped in a chair, comatose, unaware of his surroundings, unable to communicate or he would present strangely agitated behaviour.

On one occasion he stood up and sat down 17 times in ten minutes.

Q&A Professor Clive Ballard answers questions about the use of anti-psychotic drugs in the treatment of dementia

His daughter, Cheryl Byrne, is convinced it was not just the disease that reduced him to this state, but the powerful anti-psychotic drugs he was prescribed over the past three and a half years.

She says: "I never thought he was the same again after he'd been prescribed those drugs... I thought something was lost."

Cheryl tried to get her father off the medication and said that there were alternative ways of caring for him that would remove the need for these drugs.

Her battle with doctors and care homes over his treatment even led her to film her father undercover, to try to prove her case.

Her footage portrayed his state and she claimed the drugs prescribed to him helped to make him zombie-like.

Misguided

For several decades a common way to deal with the behavioural problems of people with Alzheimer's or other dementias has been to prescribe them a class of drugs commonly known as anti-psychotics.

These drugs were originally designed to deal with schizophrenia or bipolar disorder and their associated symptoms of hallucinations or delusions.

There were no benefits in behaviour and there were clearly deteriorations in some of the core symptoms Professor Clive Ballard

But the sedative properties of these drugs have meant that they are often prescribed to dementia patients who show signs of aggression and agitation.

But research funded by the Alzheimer's Research Trust suggests that many of these prescriptions have been misguided.

One of the world's leading experts in dementia, Professor Clive Ballard of King's College London, has conducted a long-term study comparing the effects of the drugs on dementia patients.

He took a group of 165 people with dementia who'd already been on the drugs for some time.

Half the group were taken off the drugs, while the other half were left half on.

After a year he found that the group still on the drugs were significantly harmed.

Could patients be cared for without such reliance on powerful drugs?

His study shows that the drugs failed to produce any significant benefits and exacerbated difficulties with thinking and communication - the distressing symptoms of Alzheimer's itself.

And, on top of all this, this class of drugs risks shortening the lives of people with dementia.

Professor Ballard told Panorama: "There were no benefits in behaviour and there were clearly deteriorations in some of the core symptoms of the disease, such as in their ability to think, particularly in their ability to communicate effectively."

Guidelines from NICE (National Institute for Clinical Excellence) published in 2006 advised clinicians to only prescribe this class of drugs to people with dementia for limited times and after exhausting alternatives first.

However they are still prescribed on a scale that costs the NHS an estimated £80 million per year.

With people living longer, the number of people with dementia is set to increase by almost 40% over the next 15 years and is expected to reach one million people by 2025.

Panorama asks whether some of the medical profession have become addicted to prescribing anti-psychotics and whether many of these patients could be better cared for without such reliance on these powerful drugs?

Panorama: Please Look After Dad, BBC One 8.30pm, Monday 3 December 2007