Agitation in dementia patients can be relieved with painkillers, new research shows

A recent study published on the British Medical Journal website has found that painkillers significantly cut agitation in dementia patients. Agitation, a common dementia symptom, is often treated using antipsychotic drugs, which can have severe side effects. Statistics suggest that each year about 150,000 patients in the UK are unnecessarily prescribed antipsychotics, which have a powerful sedative effect, and can worsen dementia symptoms, and increase the risk of stroke or even death.

Antipsychotics are often given to patients whose dementia makes them aggressive or agitated, a common symtpom of dementia. Researchers have speculated however that the agitated behaviour may sometimes be caused by pain, which patients were unable to express in other ways. This was investigated in a study using patients with moderate or severe dementia in nursing homes. Half were given painkillers with every meal, the rest continued with their usual treatments.

 After eight weeks, there was a 17% reduction in agitation symptoms in the group of patients being given painkillers - a greater improvement than would have been expected from treatment with antipsychotics.
The researchers concluded that if patient's pain was properly managed, doctors could reduce the number of prescriptions for antipsychotic drugs. The research suggests that many dementia patients being prescribed "chemical cosh" antipsychotic drugs could be better treated with simple painkillers. 

Professor Clive Ballard

Professor Clive Ballard, one of the report authors and director of research at the Alzheimer's Society, said the research findings were significant.
"At the moment, pain is very under-treated in people with dementia, because it's very hard to recognise," he said.  "I think this could make a substantial difference to people's lives - it could help them live much better with dementia."

The Alzheimer's Society is issuing new guidance calling on doctors to think much harder before prescribing antipsychotics, and to look at prescribing pain medication instead.


Research into painkiller use in dementia treatment has been going on for some time, with studies in 2001 and 2009 stating that painkillers could delay the onset or even prevent Alzheimer's disease (one of the most common forms of demenia).While the findings were considered exaggerated, this recent study shows great promise for the use of painkillers in the management of dementia, as opposed to harsher antipsychotic drugs.