Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia.
|Rationale and Comments:||Behavioral and psychological symptoms of dementia are defined as the noncognitive symptoms and behaviors, including agitation or aggression, anxiety, irritability, depression, apathy, and psychosis. Evidence shows that risks (e.g., cerebrovascular effects, mortality, parkinsonism or extrapyramidal signs, sedation, confusion and other cognitive disturbances, and increased body weight) tend to outweigh the potential benefits of antipsychotic medications in this population. Clinicians should limit the use of antipsychotic medications to cases where nonpharmacologic measures have failed and the patients’ symptoms may create a threat to themselves or others. This item is also included in the American Geriatric Society’s list of recommendations for “Choosing Wisely.”|
|References:||• American Psychiatric Association: Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias, second edition. Am J Psychiatry. 2007 Dec;164(Dec suppl):5-56. Available from: http://psychiatryonline.org/content.aspx?bookid=28§ionid=1679489.
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