Action on antipsychotic drugs and dementia, UK

A tough new action plan to tackle the over prescribing of antipsychotic drugs to people with dementia was announced by Care Services Minister Phil Hope in UK.

The action plan responds to an independent review by Professor Sube Banerjee, commissioned by the Department of Health.

Professor Banerjee’s review shows that too many people with dementia are routinely prescribed antipsychotic drugs to treat aggression and agitation, contrary to National Institute of Health and Clinical Excellence (NICE) guidance.

The action plan will include:

– a new National Clinical Director for Dementia;

– measures to ensure people with dementia and their carers have access to psychological therapies to tackle the root of agitation and aggression;

– an audit to establish definitive prescribing figures;

– clear local targets to cut antipsychotics use as a result of the audit;

– better regulation;

– collaboration with the General Medical Council (GMC) and Royal Colleges to ensure all health and social care staff have specialist training in dementia; and

– joint Department and Alzheimer’s Society guidance on what to do if a family member is given antipsychotics.

Antipsychotics prescription is necessary in certain circumstances. In line with NICE guidance, the drugs should only be used when a person is a risk to themselves or others, and where all other methods have been tried. This should be for a short period of three months only, whilst a care plan is put in place.

Care Services Minister Phil Hope said:

“It is unacceptable that antipsychotic drugs are routinely prescribed to people with dementia. More than half of people with dementia will experience agitation or aggression at some point, but NICE guidance is clear ? antipsychotics should only be given when this is really necessary. Excellent examples of practice do exist, but our action plan will help make sure this is the norm, not the exception. Our new Clinical Director will provide strong leadership, supporting the NHS and Social Care to safely reduce antipsychotics use and drive up quality. We know there are situation where antipsychotic drug use is necessary ? we’re not calling for a ban, but we do want to see a significant reduction in use. We expect the findings and recommendations to be taken into account by PCTs and all other relevant organisations. Tackling the root of the problem is vital, which is why we are improving access to psychological therapies. We are also working with the Royal Colleges to ensure all health and social care professionals are able to care for people with dementia without routinely resorting to these drugs.”

Professor Sube Banerjee, the report author, said:

“Antipsychotics are used too often in dementia; up to two thirds of the estimated 180,000 people with dementia receiving these are prescribed them unnecessarily.

“This review identifies the potential risks and benefits of these medications in dementia and presents actions that we can take to address this problem. In doing so we would provide international leadership in this complex clinical area as well as improving the quality of life and quality of care for people with dementia and their carers in England.”

Source: Department of Health, UK, UK

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