Antipsychotic Use in Dementia: Is There a Problem and Are There Solutions?
Open accessAbstract
Antipsychotics are necessary for many older adults to treat major mental illnesses or reduce distressing psychiatric symptoms. Current controversy exists over the role of antipsychotics in the management of neuropsychiatric symptoms (NPS) in persons with dementia. Although some NPS may be appropriately and safely treated with antipsychotics, a fine balance must be achieved between the benefits of these medications, which are often modest, and adverse events, which may have significant consequences. Approximately one-third of all persons with dementia are currently prescribed antipsychotic medications, and there is significant variation in the use of antipsychotics across care settings and providers. Reducing the inappropriate or unnecessary use of antipsychotics among persons with dementia has been the focus of increasing attention owing to better awareness of the potential problems associated with these medications. Several approaches can be used to curb the use of antipsychotics among persons with dementia, including policy or regulatory changes, public reporting, and educational outreach. Recently, there has been encouraging evidence of a downward trend in the use of antipsychotics in many long-term care settings, although prescribing rates are still higher than what is likely optimal. Although reducing the inappropriate use of antipsychotics is a complex task, psychiatrists can play an important role via the provision of clinical care and research evidence, contributing to improved care of persons with dementia in Canada and elsewhere.
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Communication around new or modified use of antipsychotic medications during hospitalization may provide subsequent caregivers with critical knowledge on therapeutic benefits, or lack thereof, which can inform later care management strategies.
“Additionally, communication around new or modified use of antipsychotic medications during hospitalization may provide subsequent caregivers with critical knowledge on the therapeutic benefits, or lack thereof, for the patient with dementia which can inform later care management strategies.30, 45”
From Discharge Communication of Dementia-Related Neuropsychiatric Symptoms and Care Management Strategies during Hospital to Skilled Nursing Facility Transitions (2021) · cites this paper as [30]
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- Authors
- Kirkham, J., Sherman, C., Velkers, C., Maxwell, C., Gill, S., Rochon, P., & Seitz, D.
- Affiliations
- Queen's University (CA)
- University of Waterloo (CA)
- Women's College Hospital (CA)
- Corresponding author
- Seitz, Dallas
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2016-10-08
- Volume
- 62
- Issue
- 3
- Pages
- 170-181
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- PMC
- PMC5317021
- OpenAlex
- W2529748942
- Cited by
- 113
- References
- 100
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 10 · 2023: 14 · 2022: 19 · 2021: 18 · 2020: 14 · 2019: 14 · 2018: 3 · 2017: 2
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Consortium canadien en neurodégénérescence associée au vieillissement
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- antipsychotic drugs, dementia, neuropsychiatric symptoms, inappropriate prescribing, prescribing variation, long-term care, adverse drug reactions, prescribing policy, public reporting, clinician education, role of psychiatrists
- MeSH terms
- Dementia, Humans, Drug Prescriptions, Antipsychotic Agents
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