Thioridazine for dementia

Kirchner, Vincent; Kelly, Cornelius; Harvey, Richard J.

doi:10.1002/14651858.cd000464

Cited by 27 publications

(26 citation statements)

References 31 publications

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“…There is evidence that conventional neuroleptic drugs have small but significant efficacy in controlling psychotic symptoms and certain behavioral symptoms in dementia (Lanctot et al, 1998;Kirchner et al, 2002;Lonergan et al, 2002). However, there have been concerns that they are excessively used for other symptoms as well, and legislative actions have been taken in order to restrict the use of antipsychotic drugs in long-term care settings (Lantz et al, 1996;McGrath and Jackson, 1996).…”

Section: Introductionmentioning

confidence: 99%

Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards

Pitkälä

Laurila

Strandberg

et al. 2004

Int. Psychogeriatr.

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Objectives:To describe the prevalence of various psychiatric and behavioral symptoms among patients with dementia in nursing homes and acute geriatric wards and to investigate the administration of psychotropic medications to these patients.Methods: 425 consecutive patients (>70 years) in six acute geriatric wards in two city hospitals and seven nursing homes in Helsinki, Finland, were assessed with an extensive interview, cognitive tests, and attention tests. Of these, 255 were judged to have dementia according to the following information: previous dementia diagnoses and their adequacy, results of CT scans, Mini-mental State Examination (MMSE) tests, Clinical Dementia Scale (CDR) tests, and DSM-IV criteria. Psychiatric and behavioral symptoms were recorded over two weeks for each patient.Results: Psychiatric and behavioral symptoms were very common among patients with dementia in both settings. In all, 48% presented with psychotic symptoms (delusions, visual or auditory hallucinations, misidentifications or paranoid symptoms), 43% with depression, 26% agitation, and 26% apathy. Use of psychotropic drugs was also common: 87% were on at least one psychotropic drug, 66% took at least two, 36% at least three, and 11% four or more psychotropic drugs. Of the patients with dementia, 42% were on conventional antipsychotics, and 34% on anxiolytics despite their known side-effects. Only 13% were on atypical antipsychotics and 3% on cholinesterase inhibitors. The K. H. Pitkala et al.use of selective serotonin reuptake inhibitors (SSRIs) was common (31%) among the patients. A surprising finding was that drugs with anticholinergic effects were also frequently (20%) used. Conclusion:Both behavioural symptoms and use of psychotropic drugs are very common among dementia patients in institutional settings. The frequent use of potentially harmful drugs implies a need for education among physicians taking care of these patients.

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Section: Introductionmentioning

confidence: 99%

Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards

Pitkälä

Laurila

Strandberg

et al. 2004

Int. Psychogeriatr.

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“…Since the serendipitous discovery of the antipsychotic properties of chlorpromazine in 1952, antipsychotic medications have been used in the treatment of many non‐psychotic conditions 1−8 . For example, some literature exists supporting the use of flupenthixol as an effective antidepressant 9 .…”

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confidence: 99%

Audit of antipsychotic prescribing in a private psychiatric hospital

Botvinik¹,

Ng²,

Schweitzer³

2004

Australas Psychiat

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“…Low potency typical antipsychotics (eg, chlorpromazine) may be less appropriate for older adults with dementia because of anticholinergic properties. A Cochrane review showed that there is no evidence to support the use of the low potency antipsychotic, thioridazine, in older patients with dementia and that its use may expose patients to excess side-effects (Kirchner et al 2000). Between 1964 and 2001, the UK Committee on Safety of Medicines received 42 reports of suspected heart rate and rhythm disorders associated with thioridazine (Committee on Safety of Medicines/Medicines Control Agency 2001).…”

Section: Treatment Of Neuropsychiatric Symptomsmentioning

confidence: 99%

Atypical antipsychotics to treat the neuropsychiatric symptoms of dementia

Lee¹,

Gill²,

Rochon³

2006

Neuropsychiatric Disease and Treatment

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Neuropsychiatric symptoms are common in older adults with dementia and can be associated with a rapid decline in cognitive and functional status. This article reviews the current literature supporting the use of atypical antipsychotic medications in this population. Among the currently available atypical antipsychotics, risperidone and olanzapine have been the most widely studied in double-blind, randomized, placebo-controlled clinical trials. Despite the common use of other atypical antipsychotic medications, their efficacy and safety in older adults with dementia has not been as extensively studied. Some controversy surrounds the use of atypical antipsychotic agents in older adults with the suggestion that they may increase the incidence of stroke or even death. Despite the potential for increased risk of harm from the use of these medications, atypical antipsychotics are often effective in treating troublesome neuropsychiatric symptoms refractory to other treatments. Whenever possible, these atypical antipsychotic drug treatments should be combined with non-pharmacological treatments to limit the need and dose of antipsychotic drugs and constant monitoring for potential harms should be maintained. The choice of which atypical antipsychotic agent can be guided by the nature and severity of the target symptom and the medication least likely to cause harm to the patient.

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Thioridazine for dementia

Cited by 27 publications

References 31 publications

Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards

Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards

Audit of antipsychotic prescribing in a private psychiatric hospital

Atypical antipsychotics to treat the neuropsychiatric symptoms of dementia

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