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Studies show that agitation and psychosis are among the leading risk factors for institutionalization and death in patients with dementia.
“Any antipsychotic might be useful for managing dementia-related psychosis or agitation in certain circumstances,” said Victor Reus, M.D., a professor of psychiatry at the University of California, San Francisco, and chair of the 10-member group that developed the guidelines. “The concern in the field at large has been that when people receive a prescription, it’s never changed and it continues on indefinitely, which over time carries increasing risks of morbidity and even mortality. The problem is that many patients are never reassessed,” he told Psychiatric News.
The guideline includes recommendations on assessing the psychological and behavioral symptoms of dementia; the risks and benefits of antipsychotic use; and specifics for dosing, duration, and monitoring of antipsychotic therapy to ensure thoughtful and judicious use. Additionally, the guideline emphasizes the importance of developing a comprehensive treatment plan that includes appropriate person-centered psychosocial and pharmacological treatments.
“We feel these evidence-based recommendations, with the extensive review and broad input supporting them, provide a valuable resource for clinicians, individuals, caregivers, and others,” APA President Renée Binder, M.D., wrote in her latest blog post. “The guidelines will help promote the best decisions possible for patients with dementia and symptoms of agitation and psychosis and will contribute to improving care for many older adults.”
An executive summary of the guidelines appears in the May issue of the American Journal of Psychiatry.
A complete list of APA’s Practice Guidelines can be found on PsychiatryOnline.