Prescribing patterns for psychotic and behavioural symptoms in dementia: a national survey

Abstract

Aims and MethodTo compare current prescribing practice for psychotic and behavioural symptoms in dementia with the available research. An anonymous questionnaire was sent to all members of the Faculty of Old Age Psychiatry, enquiring about preferred drug treatments.ResultsClassical antipsychotics were chosen by 50% for psychotic symptoms over atypical antipsychotics (43%) and were preferred for aggression (48%) and sexual disinhibition (55%). Antidepressants were favoured in treating anxiety (41%) and lability (45%).Clinical ImplicationsAlternatives to classical antipsychotics, especially for behavioural symptoms, have yet to be researched satisfactorily. In view of the continued widespread use of classical antipsychotics and recent concerns about their safety, we call for this to be addressed.

Inappropriate sexual behaviour and dementia: An exploration of staff experiences

“…Over 80% of people with a dementia exhibit behaviours that are perceived as challenging (Lonergan, Luxenberg, Colford & Birks, 2002;Scott et al, 2002). Challenging behaviours have been described as "unsafe and disruptive and that interfere with the care of the patient in any given environment" (Black, Muralee & Tampi, 2005, p.155).…”

“…Over 80% of people with a dementia exhibit behaviours that are perceived as challenging (Lonergan, Luxenberg, Colford, & Birks, 2002; Scott et al., 2002), and may include verbal/physical aggression, wandering and self-injury. Managing challenging behaviour is demanding, is associated with staff burnout and sub-optimal care, and can compromise community living of those who present with the behaviour (Feeney, Ylvisaker, Rosen, & Greene, 2001; Hallberg & Norberg, 1995).…”

“Behind Closed Doors with open minds?”: A qualitative study exploring nursing home staff’s narratives towards their roles and duties within the context of sexuality in dementia

“…Some studies suggest the prevalence of inappropriate sexual behaviours (ISB) amongst residents with dementia is relatively low (Alagiakrishnan et al, 2005;ILCUK, 2011;Series & Degano, 2005), but others claim that their prevalence and impact are substantial (Cubit et al, 2007;Lonergan et al, 2002;Scott et al, 2002). ISB is often seen as a part of the symptom cluster of behavioral and psychiatric disturbances associated with dementia, which is often disruptive and distressing for both patient and their carers (Johnson, Knight & Alderman, 2006).…”

«Off-Label-Use» in der alterspsychiatrischen Demenzbehandlung

“…Gerade i n der Behandlung v on psychischen u nd neuropsychiatrischen Krankheiten und Verhaltensstörungen im Alter -inklusive der Demenz -ist der Off-label-Einsatz insbesondere von Antidepressiva, konventionellen und atypischen A ntipsychotika sow ie Anxiolytika-Sedativa zunehmend Regel statt Aus nahme geworden, und dies trotz ungenügender Evidenz durch klinische Studien[7,[41][42][43][44][45][46]. Trotz von verschiedenen Seiten angekündigter Priorisierung bei der Prüfung der am h äufigsten e ingesetzten Arzneimittel[44][45][46] bleibt vorerst mangels thera-peutischerAlternativen die Aussicht auf eine weitere, für die Behandler unbefriedigende Tätigkeit im «chronischen Off-label-Use-Zustand».…”