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- Title
Stopping antipsychotic drug therapy in demented nursing home patients: a randomized, placebo-controlled study--the Bergen District Nursing Home Study (BEDNURS).
- Authors
Ruths S; Straand J; Nygaard HA; Aarsland D; Ruths, Sabine; Straand, Jørund; Nygaard, Harald A; Aarsland, Dag
- Abstract
<bold>Background: </bold>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.<bold>Aims: </bold>To explore the impact on BPSD of stopping long-term antipsychotic treatment in nursing home patients with dementia.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusion: </bold>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.
- Publication
International Journal of Geriatric Psychiatry, 2008, Vol 23, Issue 9, p889
- ISSN
0885-6230
- Publication type
journal article
- DOI
10.1002/gps.1998