Use of Zyprexa with the Elderly

Zyprexa (Olanzapine) is what is called an atypicl antipsychotic, often used off label, with the elderly who may have behavioural disturbances or dementia related psychosis. There have been warnings about this use, and now the maker, Eli Lilly is reportedly near a setlement in the U.S. concerning it's marketing of the drug. REad the story in the New York Times


http://www.nytimes.com/2009/01/15/business/15drug.html?_r=1&scp=7&sq=Zyprexa&s

And click on the link below to read about Zyprexa


http://alzheimers.about.com/od/medication/a/Olanzapine.htm

Medications and Overmedications

I have a client in a very classy nursing home where she has been for three years. She was very agitated and intrusive when first admitted, and had been seen by a couple psychiatrists who put her on various medications. I have been fighting ever since to lower them. The last time I got them lowered was about six months ago.

I finally called the family physician and asked him to lower them. The psychiatrists had been afraid to do so. He lowered them.

Guess what? No difference.

Well, no, there was a difference. Her balance is better. She is eating better. She is more alert.

There is no difference in the way the home is able to manage here care.


I think to myself, how much would she be on if I hadn't been pushing? Why don't they follow this better?

I actually know why--it is because it is easier not to. It is easier not to really and truly individualize care and provide the best care possible.

That is why people need someone like what I do or a family member to do it.

Medications Medications Medication

Oh, did I mention I wanted to say something about medications?

I was watching 20/20 the other night, and there was a segment on pharmacies. It showed many people going to pick up medications who were not given counselling and even some people who bought an over the counter medication which was contra-indicated with the prescribed medication were, in most cases, not being warned.

Over medication, undermedication, and mis-medication is one of the greatest challenges for caregivers and older people themselves. Medication problems lead to delirium, hospitalization, broken hips, depression, confusion, and death. It is essential that medication taking be monitored. There are phone services you can use, there is equipment that can be gotten which dispenses medication.

All medication should be reviewed regularly. Medications can build up easily in an older person's system. Nursing homes and assisted living housing may not review adequately all the medications.

People MUST talk to their pharmacists about new prescriptions and changes of prescriptions. The pharmacy has to know if someone is taking over the counter medications, herbal remedies, natural whatevers, and chocolate.

Okay, maybe not the chocolate.

But the others can all have interactions with prescribed medications and they can vary enormously in quality.

Caregivers need to be the advocates for their loved ones in a care facility, especially around medications. So you have to know what they are on, why, the dosage, possible side effects. If they are medications for psychological reasons or agitation, they should regularly be reviewed.