Rapid Response

To Prescribe or Not to Prescribe? Atypical Antipsychotic Drugs in Patients with Dementia

Authors: Dilip V. Jeste, MD, Thomas Meeks, MD

Abstract

Antipsychotic Drug Use and Mortality in Older Adults with Dementia


Gill SS, Bronskill SE, Normand ST, et al. Ann Intern Med 2007;146:775–786.


Recent data regarding strokes and mortality associated with atypical antipsychotic medications in older adults with dementia have caused considerable confusion and anxiety among patients and their families, clinicians, and researchers. This is an issue of clear public health significance. An estimated 4.5 million Americans have Alzheimer disease, and millions more have other forms of dementia.1 Psychosis affects about 40% of persons with Alzheimer disease,2 while up to 80% of dementia patients exhibit agitation.3 The consequences of these neuropsychiatric syndromes of dementia can include reduced quality of life for the patients, increased caregiver burden, a greater likelihood of patient institutionalization, and soaring medical costs; some studies also suggest an association of psychosis with more rapid clinical deterioration, and possibly death.4

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