Unintended Consequences – How Government Policies Led to “The Little Red Pill.”

Last month’s story from CNN about mismarketing and inappropriate administration of Nuedexta (“the little red pill”) to nursing home residents is certainly not surprising to anyone who follows the systemic drugging of people with dementia.  When CMS launched its campaign to reduce inappropriate use of antipsychotics in nursing homes in 2012, you did not need to be an oracle to figure that many nursing homes would simply shift their chemical restraint of choice from antipsychotics to some other sedating drug.  While the number of residents given antipsychotics has slowly drifted downward since 2012, the number of residents receiving equally inappropriate anti-anxiety drugs has remained flat and, we suspect though cannot confirm, the number of residents receiving sedating anti-seizure drugs, like Depakote, has increased.

During this time, as the CNN story chronicles, the use of Nuedexta has exploded, driven in part by nursing homes’ demand for a drug that subdues residents with dementia but is not “counted” by CMS.  Aggressive marketing, timing, and opportunity from short-sighted policymakers – as opposed to any real clinical efficacy – has fed the increased use of Nuedexta, just the latest nursing home psych drug craze built on empty promises and provider ignorance.