Text Box 5Safety warning regarding risperidone and olanzapine

CSM advice on balance of risks and benefits (9th March 2004)

‘The CSM has advised that there is clear evidence of an increased risk of stroke in elderly patients with dementia who are treated with risperidone or olanzapine. The magnitude of this risk is sufficient to outweigh likely benefits in the treatment of behavioural disturbances associated with dementia and is a cause for concern in any patient with a high baseline risk of stroke.

Prescribing advice

Although there is presently insufficient evidence to include other antipsychotics in these recommendations, prescribers should bear in mind that a risk of stroke cannot be excluded, pending the availability of further evidence. Studies to investigate this are being initiated.

Patients with dementia who are currently treated with an atypical antipsychotic drug should have their treatment reviewed. Many patients with dementia who are disturbed may be managed without medicines’.

From: 8, THERAPEUTIC INTERVENTIONS FOR PEOPLE WITH DEMENTIA – NON-COGNITIVE SYMPTOMS AND BEHAVIOUR THAT CHALLENGES

Cover of Dementia
Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care.
NICE Clinical Guidelines, No. 42.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2007.
Copyright © 2007, The British Psychological Society & The Royal College of Psychiatrists.

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