Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-19T12:10:49.927Z Has data issue: false hasContentIssue false
  • English
  • Français

Antipsychotic prescribing for behavioural and psychological symptoms of dementia

Published online by Cambridge University Press:  02 January 2018

Ayodeji Soyinka  and
David Lawley
Ayodeji Soyinka
Affiliation:
Old Age Psychiatry, Holly House, St Mary's Hospital, Greenhill Road, Armley, Leeds LS12 3QE, email: soyinka@mailcity.com
David Lawley
Affiliation:
Old Age Psychiatry, Humber Mental Health Teaching NHS Trust, Hull
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Aims and Method

To review the quality of information and advice contained in correspondence from old age psychiatrists to general practitioners (GPs) regarding the prescription of antipsychotic drugs for the management of behavioural and psychological symptoms of dementia. Discharge summaries (n=22) and subsequent out-patient review letters were examined and compared with evidence-based guidelines in two phases of an audit cycle; first in 2002 and latterly in 2005.

Results

Practice was below acceptable standards during both phases of the audit cycle, with an actual drop in the quality of explicit advice given to GPs in 2005, despite national publicity about the issues and guidance from the Royal College of Psychiatrists.

Clinical Implications

The prescription of antipsychotic drugs is associated with an adverse prognosis for people with dementia. As such, it is imperative that such treatment is regularly reviewed and time limited. Old age psychiatrists need to ensure that this message is communicated to their primary care colleagues.

Type
Original papers
Information
Psychiatric Bulletin , Volume 31 , Issue 5 , May 2007 , pp. 176 - 178
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2007

References

Ballard, C., Bannister, C., Graham, C., et al (1995) Associations of psychotic symptoms in dementia sufferers. British Journal of Psychiatry, 167, 537–540.CrossRefGoogle ScholarPubMed
Ballard, C. G., Thomas, A., Fossey, J., et al (2004) A 3-month randomized, placebo-controlled, neuroleptic discontinuation study in 100 people with dementia: the Neuropsychiatric Inventory median cut off is a predictor of clinical outcome. Journal of Clinical Psychiatry, 65, 114–119.CrossRefGoogle Scholar
Bouman, W. P. & Pinner, G. (2000) Use of atypical antipsychotic drugs in old age psychiatry. Advances in Psychiatric Treatment, 8, 49–58.Google Scholar
Buck, J. A. (1998) Psychotropic drug practice in nursing homes. Journal of the American Geriatrics Society, 36, 409–418.Google Scholar
Cummings, J. L., Mega, M., Gray, K., et al (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 939–944.Google Scholar
Douglas, S., James, I. & Ballard, C. (2004) Non-pharmacological interventions in dementia. Advances in Psychiatric Treatment, 10, 171–177.Google Scholar
Furniss, L., Burns, A., Craig, S. K. L., et al (2000) Effects of a pharmacist's medication review in nursing homes. Randomised controlled trial. British Journal of Psychiatry, 176, 563–567.Google Scholar
Gill, S., Rochon, P., Herrman, N., et al (2005) Atypical antipsychotic drugs and risk of ischaemic stroke: population based retrospective cohort study. BMJ, 330, 445–449.CrossRefGoogle ScholarPubMed
Inasu, P., Shaikh, F. & Lawley, D. (2004) Audit of antipsychotics in dementia. Clinician, 1, ii–iii.Google Scholar
Jenks, S. F. & Clauser, S. B. (1991) Managing behavioural problems in nursing homes. JAMA, 265, 502–503.CrossRefGoogle Scholar
McGrath, A. & Jackson, G. A. (1996) Survey of neuroleptic prescribing in residents of nursing homes in Glasgow. BMJ, 312, 611–612.CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists (2005) Atypical Antipsychotics and Behavioural and Psychiatric Symptoms of Dementia. http://www.rcpsych.ac.uk/pdf/BPSD.pdf Google Scholar
Schneider, L. S., Dogerman, K. S. & Insel, P. (2005) Risk of death with atypical antipsychotic drug treatment for dementia – Meta-analysis of randomised placebo-controlled trials. JAMA, 294, 1934–1943.Google Scholar
Shorr, R. I., Fought, R. L. & Ray, W. A. (1994) Changes in antipsychotic drug use in nursing homes during implementation of the OBRA-87 regulations. JAMA, 271, 358–362.Google Scholar
Sink, K. M., Holden, K. F. & Yaffe, K. (2005) Pharmacological treatment of neuropsychiatric symptoms of dementia. A review of the evidence. JAMA, 293, 596–608.Google Scholar
Wang, P. S., Schneeweiss, S., Avorn, J., et al (2005) Risk of death in elderly users of conventional versus atypical antipsychotic medications. New England Journal of Medicine, 353, 2335–2341.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.