In situations where first-line interventions have not succeeded or where risk of harm to the individual or others is high, psychotropic medicines including antipsychotics and benzodiazepines may be considered.3,11,15,16
It is important to remember however, that antipsychotic medicines are not effective for a majority of changed behaviours and their use is limited to behaviours such as aggression and psychosis.11,15,17
It is also estimated that only 20% of people with dementia who receive an antipsychotic medicine are likely to respond.17
In addition to these limitations, antipsychotics carry increased risk of side effects including cognitive decline, cerebrovascular events and mortality.7,15,18
If a medicine such as antipsychotic or benzodiazepine is being considered, this needs to proceed with informed consent and in consultation with the person with dementia, their family, carers and healthcare team. Quality use of medicine principles, such as lowest dose for shortest time and regular systematic review, should also be followed.3,4,7
NPS MedicineWise has a deprescribing tool available to help facilitate review of antipsychotic medicines, including advice on how and when to taper.