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Should Antipsychotic Drugs Be Used for Dementia

red pillsMedications used to treat schizophrenia and bipolar disorder have been used for years to treat other conditions, including reducing disruptive behavior among individuals diagnosed with dementia.

The August issue of the Harvard Mental Health letter reviews the use of antipsychotic medications for dementia behaviors, providing information to help friends and families of individuals with dementia.

According to the review, in the last few years, the FDA has required drug labels to carry warnings regarding off-label use, and studies continue to raise questions about its risks and benefits.

Concern about this issue is not new.

A federal law passed in 1987 provides that residents in facilities receiving government support should not receive antipsychotics for problems that are simply inconvenient for caregivers—such as wandering, insomnia, or uncooperativeness—but only for agitated, aggressive, or psychotic behavior that is distressing to the patients or dangerous to others.

But the guidelines have not prevented continued heavy use in institutions for the elderly.

There is some evidence that the drugs can help.

A review of 16 studies found that some antipsychotics might reduce agitation, aggression, and psychosis, although there was little evidence about long-term use.

But for many, the risks outweigh the benefits. The drugs may cause tremors, drowsiness, and weight gain, and they may raise the risk for high cholesterol, diabetes, and heart arrhythmias.

Despite disappointing research findings, clinicians have not given up on the use of antipsychotic drugs for dementia.

Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter notes, “If drug use is necessary, it makes sense to start at a low dose and gradually increase it. The need to continue the drug should be evaluated regularly.”

Clinicians are advised to document their reasons for prescribing the drug and their understanding of the risks and benefits.

Source: Harvard Health Publications

Should Antipsychotic Drugs Be Used for Dementia

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Should Antipsychotic Drugs Be Used for Dementia. Psych Central. Retrieved on October 23, 2018, from https://psychcentral.com/news/2007/07/26/should-antipsychotic-drugs-be-used-for-dementia/1071.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.