Behavioral changes such as aggression, agitation, and resistance to care are common in people with dementia. Research shows that antipsychotic use in these cases provides only moderate benefits while posing a high risk of side effects, including falls and cognitive decline. Additionally, studies have linked antipsychotics to increased mortality and a higher risk of stroke in this patient group. These medications should be reserved for situations where non-pharmacological interventions have been attempted without sufficient effect and where there is an immediate risk of harm to the patient or others. Identifying and addressing the underlying causes of behavioral changes can often eliminate the need for antipsychotic medication.
References:
- Helsedirektoratets nasjonale faglige retningslinje om demens https://helsedirektoratet.no/nyheter/ny-retningslinje-om-demens-god-diagnostikk-og-behandling
- Declerq T, Petrovic M, Azermai M, et al. Withdrawal versus continuation of chronic antipsychotic drugs for behavioural and psychological symptoms in older people with dementia. Cochrane Database Syst Rev 2013;(3):CD007726.
- Ma H, Huang Y, Cong Z, et al. The efficacy and safety of atypical antipsychotics for the treatment of dementia: a meta-analysis of randomized placebo-controlled trials. J Alzheimers Dis 2014;42(3):915-37.
- Richter T, Meyer G, Mohler R, Kopke S. Psychosocial interventions for reducing antipsychotic medication in care home residents. Cochrane Database Syst Rev 2012;(12):CD008634.
- Schneider LS, Tariot PN, Dagerman KS, et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease. New England Journal Med 2006;355(15):1525-38.