Some Illinois nursing home residents with dementia are unnecessarily being prescribed Nuedexta to control agitation, unruly behaviors, and confusion, and the use of this drug has been associated with falls and other adverse events that have led to hospitalization and death. The medication is meant to treat PBA, which causes uncontrollable laughing in some people who have multiple sclerosis or Lou Gehrig’s disease. Its use has not been adequately studied in elderly patients with dementia.
What Is Nuedexta?
Nuedexta is a medication that is marketed by Avanir Pharmaceuticals and is approved by the U.S. Food and Drug Administration for the treatment of a condition called pseudobulbar affect. PBA is most commonly associated with ALS or MS and affects less than 1 percent of all Americans. Despite the rarity of the disorder, prescriptions of the medication have skyrocketed in the past four years. The drug’s maker has mounted an aggressive marketing campaign to promote nonapproved uses such as the treatment of dementia. Some nursing homes have been requesting prescriptions of Nuedexta for their patients, and doctors have allegedly inappropriately diagnosed dementia patients with PBA to secure kickbacks from the manufacturer and payment from Medicare Part D.
Unfortunately, some nursing homes have actively sought prescriptions of Nuedexta for residents who don’t have PBA but who the staff finds to be troublesome. The drug has been used because it prevents people from having vocal outbursts. When it is given to people who do not need it, they may be unable to communicate their needs and may be more susceptible to injuries. A recent study demonstrated that elderly patients with Alzheimer’s who were prescribed Nuedexta fell at more than double the rate of others who were not taking the medication. Geriatric doctors have said that PBA occurs in less than 5 percent of patients with Alzheimer’s disease.
To help prevent injuries caused by the use of inappropriate medications in nursing homes, family members and caregivers should be vigilant about those being prescribed to their elderly loved ones. They should ask about the conditions their loved ones’ medications are prescribed to treat, watch for signs of side effects these drugs may cause, and take action when inappropriate medications are suspected.