Off-label use of antipsychotic drugs in nursing home patients not tracked in rural Manitoba

A gap in Manitoba's reporting system means the majority of nursing homes in the province cannot monitor how many residents are being given antipsychotic drugs without a diagnosis.

Nearly one quarter of residents in Winnipeg's 38 care homes are being given these powerful medications without a shown clinical need, a CBC investigation revealed.

But the scale of the problem in the province's other 87 homes is unknown because data is not being collected and the homes do not publicly report these numbers.

Melissa Marchischuk's 87-year-old mother has dementia and lives in a nursing home in Minnedosa. 

For the last five years her mother has been given the antipsychotic risperidone. She said her mother was not diagnosed with a mental condition the drug is meant to treat.

"I think they just try to sedate them," Marchischuk told CBC News.

"But risperidone is not the correct way to sedate them or make them calm."

Antipsychotics like risperidone are used to treat a variety of mental health conditions, but mainly for those that include psychotic symptoms, such as schizophrenia or bipolar disorder. 

Risperidone can be used in the short term to treat severe dementia of the Alzheimer's type, according to Health Canada.

Marchischuk said her mother no longer walks and is in a reclinable wheelchair. She needs to be fed and offered water, and she doesn't always make sense when she speaks.

But on occasions when she had to go to hospital and was taken off all her medications, Marchischuk said her mom's cognitive abilities improved.

"Once she gets better, she goes back on the risperidone and all is lost," Marchischuk said.

"When mom was on risperidone, she was worse. Like the fears, and whatever the mind goes through with dementia, I felt was made worse. 

The Winnipeg Regional Health Authority tracks which residents are being given the drugs without a diagnosis and reports them to the Canadian Institute for Health Information.