Nursing home residents with dementia can be taken off antipsychotics without behavioral consequences, researchers say

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Nursing homes using antipsychotic drugs for dementia care can and should take most residents off these medications, according to recently published research.

Members of the Cochrane Dementia and Cognitive Improvement Group, part of the international healthcare research organization the Cochrane Collaboration, looked at nine trials with 606 participants, most of them nursing home residents. The trials all tracked what happened when people with dementia were taken off antipsychotic medications.

After reviewing the studies, the researchers determined that it's generally safe and advisable to stop giving antipsychotics to those with behavioral symptoms of dementia, including agitation, aggression, depression, wandering and delusions.

The studies show nursing home residents can be taken off antipsychotic drugs without relapse of dementia-related behaviors, or neuropsychiatric symptoms (NPS). One exception may be older people who had more severe NPS prior to going on antipsychotics. The study results suggest discontinuing antipsychotics has few or no negative effects, and may improve verbal fluency.

“We recommend that programs that aim to withdraw older nursing home residents from long-term antipsychotics should be incorporated into routine clinical practice, especially if the NPS are not severe,” the study authors wrote.

The Centers for Medicare & Medicaid Services set a goal of reducing use of these drugs by 15% by the end of 2012. It appears facilities fell far short of that goal, although long-term care organizations continue to push for its feasibility.

The full study is published on the Cochrane Library website.

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