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Published: 4th November, 2010
by TOM FOOT

THE family of a housing campaigner who suffers from dementia are considering legal action after he was given a powerful antipsychotic drug without their consent and against “clear” government advice.

Tom Costello, from Somers Town, a lifelong housing and health campaigner, was moved from the Grove Centre in Hampstead to privately run St Andrew’s hospital in Northampton on October 7. Age Concern have backed calls for the 72-year-old to return home.

Now Mr Costello’s family are in talks with their lawyers over the administering of the drug Olanzapine during a period of four weeks by Camden & Islington Foundation Trust consultants.

Mr Costello’s brother Terry said: “We thought Tom was taken off Olanzapine when he was in the Grove – we had asked specifically that he was taken off it. But he found his way back on it somehow without us knowing. That antipsychotic drug shouldn’t be given to dementia patients – especially someone like Tom who has a heart condition.”

A spokeswoman for the Department of Health’s Medicines and Healthcare Regulatory Agency said: “The MHRA has provided clear advice to prescribers on the potential risk of antipsychotics when used in dementia. Olanzapine is not authorised for use in dementia. Elderly people are at risk from serious and life-threatening side-effects when treated with antipsychotics.”

But a spokesman for the Camden & Islington Foundation Trust insisted there was a place for some anti-psychotics in dementia treatment when there was “no alternative”.

Known as the “chemical cosh”, Olanzapine is used as an antidote to anger, rendering potentially violent patients listless and passive. 

The unlicensed use of the drug on elderly dementia patients, mainly in care homes, was investigated in a BBC Panorama special on Tuesday night in which Health Minister Paul Burstow MP said it “kills people, cuts lives short and reduces the quality of their lives”.

Mr Costello is diagnosed with Dementia with Lewy Bodies, an incurable but common form of dementia similar to Alzheimer’s and Parkinson’s.

Terry said: “As soon as he arrived in Northampton they took him off it. He hasn’t shown any signs of violence since and he is much better. They say he was moved to Northampton for specialist treatment. 

“But what they are doing up there is not revolutionary. Why can’t they do this Camden?”

Minister Burstow, who has campaigned against Olanzapine for 10 years, said on Tuesday he would cut prescriptions of the drug for dementia by two-thirds by November 2011. 

He added: “It is now time for those responsible for prescribing to take responsibility and cut the prescribing, and make sure we improve the quality of life for people with dementia.”

A Camden & Islington Foundation Trust spokesman said: “Anti-psychotic agents should never be used routinely where patients also suffer from dementia. However they can be a helpful treatment for use in specific circumstances when a patient is experiencing distressing psychotic phenomena. 

“As with any pharmacological intervention, there is always a risk/benefit analysis that needs to be considered in these situations. There is a place for short-term treatment with anti-psychotic agents in dementia when other interventions, including behavioural approaches, have failed and the patient remains distressed.” 

“Professor Sube Ban­erjee [of King’s College London Institute of Psychiatry], in his report for the Department of Health, ‘The use of antipsychotic medication for people with dementia: Time for action’, stated that some people with severe and complex risk benefit from such medication. He also suggested that there is unlikely to be any difference between the various drugs within this group in terms of their adverse effects.

“As outlined in Professor Banerjee’s report, where there is no alternative but to use anti-psychotic agents in dementia, it is the practice of C&I to review the use of these agents and to reduce or stop them as soon as possible.”