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How to Prevent Unnecessary Antipsychotic Use in Dementia

Alissa Sauer
By Alissa SauerMarch 8, 2019

Antipsychotic drugs, also known as neuroleptics, are a type of medication often prescribed to treat people with mental health issues. These drugs are also used to treat the behavioral and psychological symptoms of people with dementia. Some medical professionals are concerned, however, about an over-diagnosis of these medications as they can increase the risk of mortality for people with the disease.

Learn more about preventing unnecessary antipsychotic use in people with dementia.

The American Psychiatric Association (APA) Cautions Against Unnecessary Antipsychotic Use for Dementia

A recent report from the Government Accountability Office found that 33% of people with dementia in nursing homes are prescribed antipsychotic medication and that overall, 14% of people with the disease take an antipsychotic.

Antipsychotics help mitigate the behavioral and psychological symptoms of depression in eluding delusions and hallucinations. However, antipsychotics can be dangerous for people with dementia by increasing the risks of cardiac issues or pneumonia. Other side effects of antipsychotics include falls, hypotension, infections and strokes.

Aside from the danger of taking antipsychotics to treat symptoms of dementia, studies have been inconsistent in showing the medication to be an effective treatment for improving agitation and psychosis. The APA recommends that, except for emergencies, antipsychotics should “only be used for the a of agitation or psychosis in patients with dementia when symptoms are severe… or cause significant distress to the patient.”

The first line of defense against these symptoms should be from behavioral therapies and environmental changes, followed by medications that are not antipsychotics. The APA understands that depression, infection and pain may be leading to symptoms that are being treated by antipsychotics, not treating the real issue and just lessening the symptoms. As the use of electronic medical records increase, pharmacists will have more insight into the history of patients and be able to treat each one more effectively.

While acknowledging that antipsychotics may be necessary in case of emergencies where a person with dementia becomes dangerous to themselves or those around them, it is not recommended as a long-term therapy or solution to the negative symptoms of dementia.

Has your loved one with dementia been treated with antipsychotics? What was their antipsychotic use experience like? We’d like to hear your stories in the comments below.

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Alissa Sauer
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Alissa Sauer

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