The American Psychiatric Association released revised guidelines in May for the limited “judicious use” of antipsychotic drugs to treat agitation or psychosis in patients with dementia. A statement announcing the new recommendations pointed out that they are evidence-based and should be just one part of a comprehensive treatment plan.
“…Clinical trials show little benefit from using antipsychotic medications with these patients and the antipsychotics are associated with significant adverse effects, including increased risk of cognitive decline and increased risk of death,” the statement said.
The recommendations included a list of limitations on the use of antipsychotics, including only employing them when agitation or psychosis is severe, non-drug interventions have been tried first, risks are discussed with the patient or surrogate decision maker, dosage is begun at a minimum level and tapered off if there is “no significant response” after four weeks.
The statement added, “While the focus of the guidelines is antipsychotic therapy, they emphasize that any such medication given to dementia patients should be just one part of a comprehensive treatment plan that is person-centered and includes appropriate drug and non-drug treatments.”