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Opioid Painkiller Buprenorphine, Z Drugs for Dementia Show an Increased Risk for Harmful Side Effects

Researchers call for better dosing and alternatives approaches

A PPM Brief

Presented at the Alzheimer’s Association International Conference (AAIC), researchers examined the impact of opioid-based painkiller buprenorphine and a similar class of sleep medications known as Z drugs (zolpidem, zopiclone, and zaleplon) on dementia. These common dementia prescription drugs have been linked to harmful side effects, some upward of a three-times increase, compared to those on placebo.

Two separate studies were conducted on buprenorphine and Z drugs. The buprenorphine study was a randomized controlled trial of 162 Norwegian care home residents with advanced dementia and significant depression. A rise in side effects such as personality changes, confusion, and sedation were found in those who were assigned buprenorphine as part of their treatment pathway. These harmful side effects more than tripled compared to those on a placebo, and those taking the medication reported being significantly less active during the day.

The z-drug research compared data from 2,952 people with dementia who were newly prescribed the medication compared to 1,651 controlled subjects, to evaluate the efficacy and side effects. Findings show that people who take Z-drugs are more likely to fracture a bone than those who do not; bone fractures, in turn, are related to an increased risk of death in dementia patients.

“Research into antipsychotics highlighted that they increased harmful side effects and death rates in people with dementia,” said Clive Ballard, MD, professor of Age-Related Diseases at the University of Exeter Medical School. “We now urgently need a concerted approach to opioid-based painkillers and Z-drugs, to protect frail elderly people with dementia from fractures and increased risk of death.”

Additional insights suggested that individuals with dementia may be more susceptible to opioid-based painkillers because they over-produce the body’s natural opioids. Researchers are now calling for studies to examine alternative, non-medication approaches to treating pain and insomnia, as well as appropriate dosing of buprenorphine painkillers for dementia patients.

Last updated on: August 6, 2018
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