It's been a tough few years for antipsychotics. I feel a little bad for them. So maligned and stigmatized.
First we find out they don't really work that well, and can be dangerous and life-threatening, especially for seniors. Then the FDA warns that one commonly prescribed such drug, the adorably-named Abilify, can give people “compulsive or uncontrollable urges to gamble, binge eat, shop and have sex.”
This news is shocking, at least to me. Until now, I had absolutely no idea those symptoms could be related to antispsychotic use. I just thought they meant being American.
The prevalence of this medication is still surprisingly widespread. About 1.6 million people, including many in long-term care, received the prescription last year, which an enterprising statistician could probably quickly connect to the growing popularity of DraftKings.com, Hot Pockets Snack Bites, Amazon Prime Now and camel mating videos on the Discovery channel.
The actual scientific name is aripiprazole, which sounds a lot more credible than Abilify, but isn't nearly as much fun to rhyme in a blog headline or pharmaceutical-themed rap song. Even if the drug itself ends up being outlawed, I hope the word endures forever. It could replace the much overused “enabled”—as in, “I didn't really need an antipsychotic medication, but my physician abilified me to get some.”
Rather than criticize FDA officials for tardiness in issuing this warning, we should recognize their innate humanity and extend some compassion and understanding. After only writing on this topic for the past few minutes I'm feeling a wave of compulsive urges, so I can't imagine the temptations they face staring at the problem every day. Distracted as they've almost certainly been by bouts of uncontrollable gambling, eating, shopping and sex-having, we should just be very glad they acted when they did.
At least the AHCA national antipsychotic reduction initiative is going well, so the implications for long-term care aren't as dire as they might have been. But until off-label usage is completely curbed, you should probably disable your facility web connection, put an alligator-filled moat around the kitchen and avoid opening the delivery door to anyone looking like Jeff Bezos and carrying a bubble-wrapped platter of Hot Pockets.
Oh, and if your activity calendar includes a visit to the big city, you might be wise to avoid excursions near any casinos, adult clubs or all-you-can-eat buffets.
Things I Think is written by Gary Tetz, a national Silver Medalist and regional Gold Medal winner in the 2014 Association of Business Press Editors (ASBPE) awards program. He has amused, informed and sometimes befuddled long-term care readers worldwide since his debut with the former SNALF.com at the end of a previous century. He is a multimedia consultant for Consonus Healthcare Services in Portland, OR.