Prescribing antipsychotic medications to people with dementia

Readers may be aware of the article published in the April 16-22 2011 edition of the New Zealand Listener covering aspects of the management of dementia, titled "Good morning sweetheart". Whilst the article records many good things, it has reported only half, and a very particular half, of the views I hold on prescribing antipsychotic medications to people with dementia. What was intended as a considered shot across the bows of prescribers reads more like a thermonuclear explosion on the foredeck.I encourage all doctors and health professionals who are fellow-prescribers of these medicines to read the RANZCP's Faculty of Psychiatry of Old Age (NZ) Guidelines on the topic. These can be accessed for free on line at : http://www.bpac.org.nz/a4d/ranzcpGuide.asp and ordered for free in hardcopy form from the PHARMAC website: www.pharmaconline.co.nzThe key messages of this document stand: (1) Prescribe the right medicine at the right time for the right patient, (2) Always prescribe these medicines in tandem with non-pharmacological management for behavioural and psychological symptoms in dementia, and (3) Routinely review these medicines for possible trial withdrawal after 3 months. Matthew Croucher Psychiatrist of Old Age Christchurch, New Zealand