Nursing home residents being treated successfully with Risperdal should stay on it, researchers recommend

Off-label use of antipsychotics remains a common part of long-term care, researchers show

Taking nursing home residents with dementia off of the antipsychotic drug Risperdal might do more harm than good, according to new research.

In a study of 180 dementia care residents taking Risperdal for agitation and aggression, all participants received daily doses of Risperdal for 16 weeks. Then, 110 patients who did well and who had minimal side effects while on the drug were given either Risperdal or a placebo. According to the study results, participants who were switched to a placebo were twice as likely to relapse compared to participants who remained on the medication. Additionally, rates of side effects and death were not higher in those who continued with Risperdal.

Regulators and long-term care groups have made a big push in the last several months to reduce the use of antipsychotics in nursing homes due to research showing the drugs increase mortality. Some experts have advocated for discontinuing these medications in residents taking lower doses.

"Caregivers should be aware of the increased mortality associated with these medications in people with dementia," said the study's co-author D.P. Devanand, M.D., director of the division of geriatric psychiatry at Columbia Psychiatry and the New York State Psychiatric Institute. However, he said, "if a patient is taking an antipsychotic and doing reasonably well without any major side effects, they should stay on it," HealthDay News, reported.

The study was published in the Oct. 18 issue of the New England Journal of Medicine.