SUMMARYThe mental and physical capacity of all persons living permanently in a nursing home in Bergen were estimated and their neuroleptic drug consumption and duration of stay were registered. Fifty-one per cent were severely and 14% moderately mentally impaired. Eighty-seven per cent demanded more extensive nursing care. Physical dependence was significantly associated with mental decline, but not with age. 32.6% received regularly neuroleptic medication, which was most common among restless and wandering residents. Dosage fell with increasing age and decreasing ability to perform personal hygiene.

A. VOLLSET SUMMARYIn a prospective study, the routine handling of psychotropic drugs in five nursing homes in Bergen, Norway, was examined in patients who were admitted to a permanent stay. A follow-up was performed after 3 months. Of the 83 patients who were admitted 64% consumed psychotropic drugs, at follow-up 68%. Both at admittance and after 3 months one-third of the residents were treated with antipsychotics. For antipsychotics alone evident changes were observed during the observation time. The consumers were more liable to be demented, restless and wandering, The study confirms the high number of residents using psychotropic drugs. It is concluded that 'overprescription' seems to be a general way of treating disruptive behaviour and not confined to nursing homes.

A double-blind controlled trial was carried out in 73 hospitalized elderly patients to evaluate the effect of different low doses of the neuroleptic, zuclopenthixol, on behavioural disorders associated with dementia. Patients were randomized into four groups and received treatment for 4 weeks with fixed daily doses of 2 mg, 4 mg or 6 mg zuclopenthixol, or with a dose which could be increased from 4 mg to 20 mg daily. The dose could also be reduced if necessary. Fifty-four of the patients remained on the same daily dose throughout the study. The results of symptom assessments showed that there was a significant improvement from baseline scores in all of the dose groups and, with the exception of patients on 2 mg daily, this was evident after only 1 week of treatment. Although improvement was noted in all the symptoms evaluated, the best effect was achieved on aggressive behaviour, restlessness/agitation, sleep disorders, and shouts/torments others. Only a few, relatively mild side-effects were recorded and there was no increase in frequency with increasing doses. There was significant correlation between the serum concentration and the dose of zuclopenthixol used but not in connection to age and clinical efficacy.

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