Public Health and Primary CareReview Article

Reducing Off Label Antipsychotic Use in Older Community Dwelling Adults With Dementia: A Narrative Review

Kevin T. Bain, PharmD, MPH, CPH; Emily J. Schwartz, PharmD; and Rengena Chan-Ting, DO, CMD
Notes and Affiliations
Notes and Affiliations

Received: November 11, 2016

Accepted: December 12, 2016

Published: July 1, 2017

J Osteopath Med; 117(7): 441-450

The off label use of antipsychotics for the management of behavioral and psychologic symptoms of dementia (BPSD) in older adults (age ≥65 years) is common, despite evidence of modest benefits and serious risks. Although national initiatives aimed at reducing antipsychotic use among older adults with BPSD in nursing homes have been successful, similar initiatives are lacking for community-dwelling adults with dementia. As a result, older adults with BPSD residing in the community may be at an even greater risk of being negatively affected by antipsychotic use. Physicians should be knowledgeable of this issue and understand the alternatives to antipsychotics, as well as how to reduce antipsychotic use in patients with dementia who are already taking antipsychotics.

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