NPS warns of use of antipsychotics and dementia

18 November, 2011
A new warning from Australia’s NPS: Better choices, Better health has advised against the long term use of anti-psychotic medications for people with dementia.

This official warning has been issued due to the possibility of serious and potentially life-threatening side effects of the medications.  

Anti-psychotic medications are often prescribed to people with dementia who are experiencing Behavioural and Psychological Symptoms of Dementia (BPSD). These symptoms can include calling out, wandering, aggression or depression.  

The warning advises that if a person with dementia starts to display such symptoms, the best practice approach involves look first for any environmental or physical changes that might be causing the symptoms, and trying a range of non-pharmacological measures to address these. Underlying causes of BPSD can include things such as an un-diagnosed fracture or pressure sore causing pain, or a change in accommodation or routine that is causing confusion or stress to the person with dementia. Health professionals are also advised to assess for any underlying medical issues that need to be addressed before considering a prescription of antipsychotics.  

In cases where other causes of BPSD can not be found or are unavoidable, and non-pharmacological approaches have been tried without success, the NPS advises that antipsychotic medications may be warranted to help alleviate the symptoms. If this is the case, the warning advises that the medications and any side-effects need to be closely monitored, and that they should only be used for short periods of up to 6-10 weeks. After such a time period, many of the behavioural and psychological symptoms of dementia are likely to have resolved themselves naturally, and the continuation of antipsychotic treatment is likely to incur more risks than benefits. Any enduring behavioural or psychological symptoms will need to be re-assessed, with a view to exploring other options that may be available to alleviate the person’s BPSD.  

The NPS has a new education program that provides direction on how to assess for possible causes of BPSD, and provides advice on the prescription and management of anti-psychotic medications after non-drug related approaches have been investigated.  

You can read more about the drugs use to relieve BPSD here.  

You may also like to download a copy of a presentation by Associate Professor Gerard Byrne: Antipsychotic Medication in People with Dementia.  

Visit the NPS website for more information on their new education program.