[Dysphagia] medication effects on swallowing

[HAL9600 at aol.com (HAL9600@aol.com)]

Is there any literature of which you are aware studying effects of 
anti-psychotics on swallowing of brain injured individuals?

Gerry Brooks
--
Gerry Brooks, MA, CCC, CBIT
Brain Injury Program Director
Northeast Center for Special Care
Lake Katrine, New York 12449
northeastcenter.com


In a message dated 10/3/05 12:50:58 PM Eastern Daylight Time, 
scott-dailey@uiowa.edu writes:

<< Subj:     RE: [Dysphagia] medication effects on swallowing
 Date:  10/3/05 12:50:58 PM Eastern Daylight Time
 From:  scott-dailey@uiowa.edu (Dailey, Scott)
 Sender:    dysphagia-bounces@b9.com
 To:    eripley@yahoo.com (Irene Campbell-Taylor), dysphagia@b9.com
 
 Similarly, the effects with developmentally disabled individuals are not
 widely known either.  On another note, there is little documentation of
 the possible interactions between medications when a person is on
 multiple, multiple meds.  (medications for the side effects of other
 medications).  It is always a good idea to find a good pharmacist who
 can help review medication lists when your own searches have not offered
 much info.  In my experience the pharmacists have more extensive
 knowledge of the side effects than do the prescribing physicians (this
 is not always the case, some physicians are excellent in regard to this)
 
 Scott
 
 Scott Dailey, M.A., CCC-SLP
 Speech-Language Pathologist II
 University of Iowa Hospitals & Clinics
 200 Hawkins Dr
 Iowa City, IA 52242
 (319)356-7030
 
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 -----Original Message-----
 From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On
 Behalf Of Irene Campbell-Taylor
 Sent: Monday, October 03, 2005 8:58 AM
 To: dysphagia@b9.com
 Subject: [Dysphagia] medication effects on swallowing
 
 For over twenty five years I have been trying to get physicians to
 recognize that certain medications, especially in the elderly, have a
 direct deleterious effect on the ability to swallow. When I first
 pointed out the relationship between antipsychotics and parkinsonism
 leading to deglutition disturbance, I was told that "there was no such
 evidence in the psychaitric literature" even though there certainly was.
 I'm gald to say that, by now, the effects are somewhat better identified
 although still far from widely known. The recent argument has been that
 the newer "atypical" antipsychotics do not have these effects although
 clinically and by report they certainly do. The latest, large study,
 just released, confirms this. I urge all who work with the elderly to
 pay particular attention not only to antipsychotic use but to
 medications in general as the cause of your patients' swallowing
 impairment, especially thise who are diagnosed as "dementing."
 Please see:
 
 Atypical Antipsychotics Raise the Risk of Parkinsonism
 
 NEW YORK (Reuters Health) Sept 30 - Atypical antipsychotics, especially
 when given in higher doses, significantly increase the risk of
 parkinsonism, Canadian researchers report in the September 12th issue of
 Archives of Internal Medicine. The risk, they say, may be no less than
 that with the older typical antipsychotics.
 
 In fact, lead investigator Dr. Paula A. Rochon told Reuters Health that
 "physicians may have been optimistic that these drugs don't have side
 effects, but we are finding out that they do. And they are dose related.
 We need to think about whether we need the drug at all and, if so,
 reassess the dose."
 
 Dr. Rochon of Baycrest Centre for Geriatric Care, Toronto and colleagues
 investigated the potential association between exposure and the
 subsequent development of parkinsonism with atypical relative to typical
 antipsychotics in more than 25,000 elderly patients with dementia.
 
 Compared to patients treated with atypical antipsychotics, the authors
 report, patients given typical antipsychotics were 30% more likely to
 develop parkinsonism. Patients not treated with antipsychotics were 60%
 less likely than those given atypical antipsychotics to develop
 parkinsonism.
 
 There was no difference in the incidence of parkinsonism between
 patients treated with atypical antipsychotics and those given
 lower-potency typical antipsychotics.
 
 However, among patients treated with atypical antipsychotics, the
 researchers note, those given a high-dose agent were more than twice as
 likely as those given a low-dose agent to develop parkinsonism.
 Moreover, patients dispensed a high-dose atypical antipsychotic were at
 a similar risk for parkinsonism as patients dispensed a typical
 antipsychotic.
 
 Given these findings, Dr. Rochon concluded by noting that when atypical
 antipsychotics are being used, "it's always worth considering whether
 our patients still need that dose or whether it could be decreased."
 
 Arch Intern Med 2005;165:1882-1888
 
  
 
 
 
 Dr I Campbell-Taylor
 Clinical Neuroscientist
 Exclusive Distributor:
 www.interactivetherapy.com
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