When Reducing Antipsychotic Use in Dementia Patients Might Harm More Than Help

Health policymakers have advocated reducing antipsychotic prescriptions in demented patients because of links to increased morbidity and mortality. However, questions remain as to whether these adverse outcomes reflect underlying behavioral conditions for which the antipsychotics were prescribed or medication effects per se. To investigate how altering pharmacological and nonpharmacological interventions might affect demented nursing-home patients, investigators randomized 16 U.K. nursing homes for 9-month trials of various combinations of rigorous antipsychotic review, increased social interaction, and exercise.

Of the 277 patients (74% female), 18% were taking antipsychotics, and 87% had moderate or severe dementia. Antipsychotic review co…