Don't use antipsychotics routinely to treat agitation and aggression in people with dementia

BMJ (Online)

Volumn 349, Issue , 2014, Pages

  Corbett, Anne ^a   Burns, Alistair ^b   Ballard, Clive ^a  

^a KING'S COLLEGE LONDON   (United Kingdom)

^b UNIVERSITY OF MANCHESTER   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARIPIPRAZOLE; ATYPICAL ANTIPSYCHOTIC AGENT; BENZODIAZEPINE DERIVATIVE; CARBAMAZEPINE; CITALOPRAM; HALOPERIDOL; MIRTAZAPINE; NEUROLEPTIC AGENT; OLANZAPINE; PLACEBO; PRAZOSIN; QUETIAPINE; RISPERIDONE;

AGGRESSION; AGITATION; ALZHEIMER DISEASE; ARTICLE; BEHAVIOR DISORDER; CEREBROVASCULAR DISEASE; COGNITIVE DEFECT; DEMENTIA; DISTRESS SYNDROME; DRUG EFFICACY; DRUG FATALITY; DRUG WITHDRAWAL; EXTRAPYRAMIDAL SYMPTOM; GAIT DISORDER; HUMAN; INFECTION; LICENSING; MENTAL DISEASE; PERIPHERAL EDEMA; PRACTICE GUIDELINE; PRESCRIPTION; PSYCHOSIS; QT PROLONGATION; RANDOMIZED CONTROLLED TRIAL (TOPIC); RESTLESSNESS; SOCIAL INTERACTION; SOMNOLENCE; UNSPECIFIED SIDE EFFECT; CLINICAL PRACTICE; DRUG EFFECTS; DRUG SUBSTITUTION; HUMAN RELATION; LONG TERM CARE; PATIENT CARE PLANNING; PROCEDURES; PSYCHOLOGY; PSYCHOMOTOR AGITATION; PSYCHOTHERAPY; TREATMENT OUTCOME;

AGGRESSION; ANTIPSYCHOTIC AGENTS; DEMENTIA; DRUG SUBSTITUTION; HUMANS; INTERPERSONAL RELATIONS; LONG-TERM CARE; PATIENT CARE PLANNING; PHYSICIAN'S PRACTICE PATTERNS; PRACTICE GUIDELINES AS TOPIC; PSYCHOMOTOR AGITATION; PSYCHOTHERAPY; RISPERIDONE; TREATMENT OUTCOME;

EID: 84910033393     PISSN: 09598146     EISSN: 17561833     Source Type: Journal    
DOI: 10.1136/bmj.g6420     Document Type: Article

References (22)

1. Barnes TR, Banerjee S, Collins N, Treloar A, McIntyre SM, Paton C. Antipsychotics in dementia: prevalence and quality of antipsychotic drug prescribing in UK mental health services. Br J Psychiatry 2012;201:221-6.
2. Rabins PV, Blacker D, Rovner BW, Rummans T, Schneider LS, Tariot PN, et al. American Psychiatric Association practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Second edition. Am J Psychiatry 2007;164(12 suppl):5-56.
3. National Institute for Health and Care Excellence. Dementia: supporting people with dementia and their carers in health and social care. 2006. http://publications.nice.org.uk/dementia-cg42.
4. Schneider LS, Dagerman K, Insel PS. Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. Am J Geriatr Psychiatry 2006;14:191-210.
5. Ballard C, Waite J. The effectiveness of atypical antipsychotics for the treatment of aggression and psychosis in Alzheimer's disease. Cochrane Database Syst Rev 2006;1:CD003476.
6. Ballard C, Howard R. Neuroleptic drugs in dementia: benefits and harm. Nat Rev Neurosci 2006;7:492-500.
7. Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005;294:1934-43.
8. US Federal Drugs Agency. Public health advisory: deaths with antipsychotics in elderly patients with behavioural disturbances. 2005. www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm053171.
9. De Deyn PP, Rabheru K, Rasmussen A, Bocksberger JP, Dautzenberg PL, Eriksson S, et al. A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms of dementia. Neurology 1999;53:946-55.
10. Brodaty H, Ames D, Snowdon J, Woodward M, Kirwan J, Clarnette R, et al. A randomized placebo-controlled trial of risperidone for the treatment of aggression, agitation, and psychosis of dementia. J Clin Psychiatry 2003;64:134-43.
11. Katz IR, Jeste DV, Mintzer JE, Clyde C, Napolitano J, Brecher M. Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial. Risperidone Study Group. J Clin Psychiatry 1999;60:107-15.
12. Schneider LS, Tariot PN, Dagerman KS, Davis SM, Hsiao JK, Ismail MS, et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease. N Engl J Med 2006;355:1525-38.
13. Ballard C, Margallo-Lana M, Juszczak E, Douglas S, Swann A, Thomas A, et al. Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial. BMJ 2005;330:874.
14. Devanand DP, Pelton GH, Cunqueiro K, Sackeim HA, Marder K. A 6-month, randomized, double-blind, placebo-controlled pilot discontinuation trial following response to haloperidol treatment of psychosis and agitation in Alzheimer's disease. Int J Geriatr Psychiatry 2011;26:937-43.
15. Declercq T, Petrovic M, Azermai M, Vander Stichele R, De Sutter AI, van Driel ML, 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.
16. Ballard C, Hanney ML, Theodoulou M, Douglas S, McShane R, Kossakowski K, et al. The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol 2009;8:151-7.
17. Ballard C, Lana MM, Theodoulou M, Douglas S, McShane R, Jacoby R, et al. A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (the DART-AD trial). PLoS Med 2008;5:e76.
18. Ballard C, Corbett A. Agitation and aggression in people with Alzheimer's disease. Curr Opin Psychiatry 2013;26:252-9.
19. Porsteinsson AP, Drye LT, Pollock BG, Devanand DP, Frangakis C, Ismail Z, et al. Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA 2014;311:682-91.
20. Corbett A, Husebo B, Malcangio M, Staniland A, Cohen-Mansfield J, Aarsland D, et al. Assessment and treatment of pain in people with dementia. Nat Rev Neurol 2012;8:264-74.
21. Testad I, Corbett A, Aarsland D, Lexow KO, Fossey J, Woods B, et al. The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: a systematic review. Int Psychogeriatr 2014;26:1083-98.
22. Medicines and Healthcare Regulatory Agency. Antipsychotic drugs. www.mhra.gov.uk/Safetyinformation/Generalsafetyinformationandadvice/Productspecificinformationandadvice/Product-specificinformationandadvice-A-F/Antipsychoticdrugs/index.htm.