Reacción a "Reactions: Use of antipsychotics for dementia associated with more harm than previously thought, study finds"

Antipsychotic drugs are used to treat severely agitated behaviour and distressing delusions and hallucinations in people with dementia when non-drug treatments have been tried and found to be unhelpful. We aim to use the drugs in as few people with dementia as possible and, when we do use them, this should be at the lowest doses and for the shortest times. Although we have been aware of the potential dangers of treatment for many years, this study highlights that risks of pneumonia, bone fractures and stroke are particularly raised when people with dementia are treated with an antipsychotic drug.

The study couldn’t exclude reverse causality – where the presence of a physical illness like pneumonia might lead to delirium which could then be treated with an antipsychotic drug – but all of us who prescribe in this situation should be mindful of the risks of treatment. Initiation of these drugs in people with dementia should only ever be under specialist supervision, with involvement of patients and family members in informed discussion and review.