Conference Coverage
“Inappropriate use of antipsychotics is an old story, yet we are still talking about it,” said Dr. Brodaty. “We have the knowledge and now we have to build on this knowledge and change practice. As a side issue, informed consent was pretty well lacking, and there is a lack of accountability about getting informed consent.”
Incentives for the owners, managers, and staff of nursing homes, as well as education for patients’ families, could promote person-centered care and reduce the inappropriate use of antipsychotics.
“Our next steps are to look at the prn medication and represcribing patterns. We are curious as to why some people seemed to need the antipsychotics,” said Dr. Brodaty. Although antipsychotics may be falling from favor, “there is a place for the use of antipsychotics, and our skill as clinicians is trying to identify which patients benefit from them,” Dr. Brodaty concluded.
—Erik Greb
Suggested Reading
Ballard C, Hanney ML, Theodoulou M, et al. The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol. 2009;8(2):151-157.
Declercq 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.
Devanand DP, Mintzer J, Schultz SK, et al. Relapse risk after discontinuation of risperidone in Alzheimer’s disease. N Engl J Med. 2012; 367(16): 1497–1507.
Rabey JM, Prokhorov T, Miniovitz A, et al. Effect of quetiapine in psychotic Parkinson’s disease patients: a double-blind labeled study of 3 months’ duration. Mov Disord. 2007;22(3):313-318.