Are atypical antipsychotics safer than typical antipsychotics for treating behavioral and psychological symptoms of dementia?
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Atypical antipsychotics seem to be preferable than conventional agents in treating psychological symptoms of dementia (BPSD), because they have substantially lower risks of extrapyramidal neurological effects with lower reported rates of parkinsonism and tardive dyskinesia. However, in the course of time, with the increase in their use, more and more side effects have been reported. The benefits and risks of antipsychotic treatment should be carefully evaluated according to the co-morbidity and the severity of the psychological and behavioral symptoms and their impact on the individual elderly patient. It is recommended to keep those medications in the lower range of therapeutic doses. Due to the complexity of the individual patient, no guidelines have been yet established. Therefore, clinical judgment should be used in applying the dose and the type of those drugs.
Key wordsElderly dementia conventional antipsychotics atypical antipsychotics BPSD
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- 14.Lonergan E, Luxenberg J, Colford JM, Birks J. Haloperidol for agitation in dementia. Cochrane Database Syst Rev 2002;(2):CD002852.Google Scholar
- 33.American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry 2004;65:267–272.CrossRefGoogle Scholar
- 36.Lieberman JA. Metabolic changes associated with antipsychotic use. Prim Care Companion Clin Psychiatry 2004;6:8–13.Google Scholar
- 37.Rosack J. FDA to require diabetes warning on antipsychotics. Psychiatr News 2003;38:1.Google Scholar
- 38.Show 28: warning about hyperglycemia and atypical antipsychotic drugs [webcast]. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=28. FDA Safety News. June, 2004.
- 44.Lieberman JA. Managing anticholinergic side effects. Prim Care J Clin Psychiatry 2004;6:20–23.Google Scholar
- 46.Summary of clinical trial data on cerebrovascular adverse events (CVAEs) in randomized clinical trials of risperidone conducted in patients with dementia. London, UK. Medicines and Healthcare Products Regulatory Agency, 2004.Google Scholar
- 47.Douglas IJ. Exposure to antipsychotics and risk of stroke: self controlled case series study. Brit Med J 2008;1227–1232.Google Scholar
- 49.Gill SS, Rochon PA, Herrmann N, et al. Atypical antipsychotic drugs and risk of ischemic stroke: population based retrospective cohort study. BMJ, 2005 doi:10.1136/bmj.38330.470486.8F (Epub 2005 January 24).Google Scholar
- 53.FDA-US. Food and Drug Administration: 2009 Public Health Advisories: Deaths with antipsychotics in elderly patients with behavioral disturbances. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm053171.htm
- 55.Gill SS, Bronskill SE, Normand SL, et al. Antipsychotic drug use and mortality in older adults with dementia. Ann Inter Med 2007;146:775–786.Google Scholar