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Dementia is estimated to affect around 750,000 people in the UK.1 Antipsychotics are sometimes used in such people. However, this use is not always appropriate and longer-term use is associated with serious unwanted effects, including mobility problems, sedation and sometimes death.1 Such concerns are not new. For instance, DTB highlighted them in a review on the safety of antipsychotics in 2007,2 and the National Institute for Health and Clinical Excellence recommends against the use of antipsychotics in people with Alzheimer's disease or certain other types of dementia, owing to the increased risk of cerebrovascular adverse events and death.3
Now, the Dementia Action Alliance has called for GPs, pharmacists and other groups, to commit to ensuring that a clinical review of the use of antipsychotic drugs for people with dementia takes place by 31 March 2012.1 To assist health and social care professionals, and patients and their carers, to do this, it has produced best practice guidance (available at http://www.alzheimers.org.uk). The Alliance consists of over 40 health and social care organisations (including the Department of Health and the Care Quality Commission) and seeks both public and political commitment to respond more effectively to dementia in England by 2014.
Comment: We support the call to review antipsychotic prescriptions for people with dementia, and would like to see it rolled out to the whole of the UK. Commitment from health and social care organisations will hopefully bring about a change for the better in the care for people with dementia. However, a key point is that prescribers may not know of, or have access to, other means of managing disruptive behaviour in patients with dementia other than through use of such medication. Unless this issue is also addressed, the review of the use of such treatment might not actually make that that much difference.
1. Dementia Action Alliance, 2011. The right prescription: a call to action on the use of antipsychotic drugs for people with dementia [online]. Available: http://www.dementiaaction.org.uk/news/article/6/the_right_prescription_a_call_to_action_on_the_use_of_antipsychotic_drugs_for_people_with_dementia [Accessed 21 July 2011].
2. How safe are antipsychotics in dementia? DTB 2007; 11: 81–5.
3. National Institute for Health and Clinical Excellence, November 2006 (amended March 2011). Dementia: supporting people with dementia and their carers in health and social care [online]. Available: http://www.nice.org.uk/nicemedia/live/10998/30318/30318.pdf [Accessed 21 July 2011].