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Int J Geriatr Psychiatry. 2008 Sep;23(9):889-95. doi: 10.1002/gps.1998.

Stopping antipsychotic drug therapy in demented nursing home patients: a randomized, placebo-controlled study--the Bergen District Nursing Home Study (BEDNURS).

Author information

1
Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. sabine.ruths@isf.uib.no

Abstract

BACKGROUND:

Despite modest efficacy, unpredictable individual utility, and a high rate of adverse effects, behavioural and psychological symptoms of dementia (BPSD) are common determinants for antipsychotic drug therapy in nursing home patients.

AIMS:

To explore the impact on BPSD of stopping long-term antipsychotic treatment in nursing home patients with dementia.

METHODS:

Fifty-five patients (43 women; mean age 84.1) taking haloperidol, risperidone, or olanzapine for BPSD were randomly assigned to cessation (intervention group, n=27) or continued treatment with antipsychotic drugs (reference group, n=28) for 4 consecutive weeks. The Neuropsychiatric Inventory (NPI) Questionnaire was used to examine changes in behavioural and psychological symptoms.

RESULTS:

By study completion, 23 of the 27 intervention group patients were still off antipsychotics. Symptom scores (NPI) remained stable or even improved in 42 patients (intervention group, 18 out of 27; reference group, 24 out of 28; p=0.18). As compared to patients with stable or improved symptom scores, patients with behavioural deterioration after antipsychotic cessation used higher daily drug doses at baseline (p=0.42).

CONCLUSION:

A large share of elderly nursing home patients on long-term treatment with antipsychotics for BPSD, do well without this treatment. Standardized symptom evaluations and drug cessation attempts should therefore be undertaken at regular intervals.

PMID:
18306150
DOI:
10.1002/gps.1998
[Indexed for MEDLINE]

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