Skip to main content Accessibility help
×
Home

Improving psychotropic medication use among persons with dementia

  • Donovan T. Maust (a1)

Extract

The use of psychotropic medication among persons with dementia (PWD) both in nursing home (Wetzels et al., 2011) and community settings (Maust et al., 2016) far exceeds what might be expected based on their limited evidence for benefit (Kales et al., 2015). This relatively high use persists despite years of evidence about the potential harms associated with their use in older adults generally and PWD in particular (e.g. Wang et al., 2001; Schneider et al., 2005). However, the solution to relatively high psychotropic use is not to end all psychotropic use, as there are individual patients for whom use of such medication is appropriate. For example, a policy that defines all antipsychotic use as inappropriate may simply lead to increased use of alternatives with even less evidence of benefit, as suggested by the response to antipsychotics’ black box warning in the United States (Kales et al., 2011).

Copyright

Corresponding author

References

Hide All
Kales, H. C., Gitlin, L. N. and Lyketsos, C. G. (2014). Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel. Journal of the American Geriatrics Society, 62, 762769.
Kales, H. C., Gitlin, L. N. and Lyketsos, C. G. (2015). Assessment and management of behavioral and psychological symptoms of dementia. BMJ, 350, h369h369.
Kales, H. C. et al. (2011). Trends in antipsychotic use in dementia 1999–2007. Archives of General Psychiatry, 68, 190197.
Maust, D. T., Langa, K. M., Blow, F. C. and Kales, H. C. (2016). Psychotropic use and associated neuropsychiatric symptoms among patients with dementia in the USA. International Journal of Geriatric Psychiatry. Epub ahead of print. doi: 10.1002/gps.4452.
Maust, D. T. et al. (2011). Telephone-based behavioral health assessment for older adults starting a new psychiatric medication. American Journal of Geriatric Psychiatry, 19, 851858.
Schneider, L. S., Dagerman, K. S. and Insel, P. (2005). Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA, 294, 19341943.
van der Spek, K. et al. (2016). Only 10% of the psychotropic drug use for neuropsychiatric symptoms in patients with dementia is fully appropriate. The PROPER I-study. International Psychogeriatrics. Epub ahead of print. doi:10.1017/S104161021600082X.
Wang, P. S., Bohn, R. L., Glynn, R. J., Mogun, H. and Avorn, J. (2001). Hazardous benzodiazepine regimens in the elderly: effects of half-life, dosage, and duration on risk of hip fracture. American Journal of Psychiatry, 158, 892898.
Wetzels, R. B., Zuidema, S. U., de Jonghe, J. F. M., Verhey, F. R. J. and Koopmans, R. T. C. M. (2011). Prescribing pattern of psychotropic drugs in nursing home residents with dementia. International Psychogeriatrics, 23, 12491259.
Wiechers, I. R., Kirwin, P. D. and Rosenheck, R. A. (2014). Increased risk among older veterans of prescribing psychotropic medication in the absence of psychiatric diagnoses. American Journal of Geriatric Psychiatry, 22, 531539.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed