Why are antipsychotics contraindicated in dementia?

The 2012 American Geriatric Society (AGS) Beers consensus criteria for safe medication use in the elderly (7) recommend avoiding antipsychotics to treat NPS of dementia due to the increased mortality and CVAE risk “unless nonpharmacological options have failed and patient is threat to self or others”.

Which antipsychotic should be avoided in geriatric patients?

Clozapine, ziprasidone, and conventional antipsychotics (especially low- and mid-potency) should be avoided in patients with QTc prolongation or congestive heart failure.

Why are antipsychotics bad for elderly?

In addition, typical antipsychotics lack therapeutic efficacy on behaviors such as wandering, apathy, withdrawal, hypersexuality, and symptoms of executive dysfunction or other cognitive aspects of dementia.

Should Seroquel be given to dementia patients?

It’s best to start with the lowest dose possible. If there have been visual hallucinations or other signs of possible Lewy-Body dementia, quetiapine is usually the safest first choice.

Is Abilify safe for elderly?

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Abilify (aripiprazole) is not approved for the treatment of patients with dementia-related psychosis [see Boxed Warning].

What antipsychotic drugs are used for dementia?

Doctors often prescribe powerful antipsychotic drugs to treat these behaviors:

  • Aripiprazole (Abilify and generic)
  • Olanzapine (Zyprexa and generic)
  • Quetiapine (Seroquel and generic)
  • Risperidone (Risperdal and generic).

What is the black box warning for Seroquel?

The adverse side effect profile of quetiapine may not outweigh the benefits of the low dose. Quetiapine has a black box warning of potentially increasing the mortality of elderly patients with dementia-related psychosis.

Is Seroquel good for elderly dementia patients?

Seroquel is not approved for the treatment of patients with dementia-related psychosis [see Warnings and Precautions (5.1)]. Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies.

Are antipsychotics killing elderly patients?

Antipsychotics were long considered the most dangerous medications used in psychiatry. Then their reputation got worse. It is new evidence that antipsychotics can cause harm and even death in demented (most often elderly) patients that has led to articles like the one in this week’s Science Times about overprescribing. The problem appears to include older medicines, like Haldol and Thorazine

How dangerous are antipsychotic medications for dementia?

The Food and Drug Administration cautions that antipsychotic drugs are dangerous and possibly fatal for people with dementia, increasing the risk of falls, stroke, diabetes, heart attack and death.

Are antipsychotics used appropriately for managing dementia?

Antipsychotics, including those listed above, still have a role to play in treating people with Alzheimer’s and related dementia. They should not be used, however, unless the person exhibiting extreme behaviors has failed to respond to non-drug management strategies. For more on those strategies, see below.