Many older people with Alzheimer’s dementia and behavioral symptoms can be withdrawn from chronic antipsychotic medication without detrimental effects on their behaviour.
A subgroup of the international healthcare research organization the Cochrane Collaboration, recently tracked what happened when people with dementia were taken off antipsychotic medication, even those showing signs of agitation, delusions, wandering, aggression or depression. Prevention is a more cost-effective alternative strategy.
Researchers advised that taking residents with dementia off antipsychotics should be “routine clinical practice”.(1) That they can do so without fear of relapse of the responsive behaviors. There are exceptions however, for those with more severe neuropsychiatric symptoms before starting antipsychotics.
There is evidence that depression and aggression are associated, in spite of the apparent contraindications. Isolation and lost social support contributes to depression.(2) However, the 2008 National Institute of Mental Health (NIMH) Strategic Plan includes prevention as one of its key objectives with respect to mental disorders such as depression.(3)
Approaching depression through prevention is a more effective and cost-saving strategic approach to improve quality of life as well as enhancing health span and the life span.
References
(1) www.summaries.cochrane.org/CD007726/withdrawal-of-chronic-antipsychotic-drugs-for-behavioural-and-psychological-symptoms-in-older-people-with-dementia
(2) www.nimh.nih.gov/about/strategic%2Dplanning%2Dreports/
(3) Dutton, D. G., & Karakanta, C. (2013). Depression as a risk marker for aggression: A critical review. Aggression and violent behavior, 18(1), 310-319.