Since 2012, the Centers for Medicare & Medicaid Services (CMS) has mandated the reduction of unnecessary antipsychotic medication use, especially when used off-label to control “behaviors” in those with dementia. Treatment plans at many nursing homes have shifted to no-pharmacological interventions wherever possible.
But, for certain types of dementia being treated with the drug risperidone, sticking to that treatment might be the best course of action, according to data presented at the Alzheimer’s Association International Conference published in the New England Journal of Medicine.
Research conducted by a large, multi-state team showed that many people with Alzheimer’s disease who were taking risperidone (also called Risperdal) for psychoses or agitation tended to relapse if the drug was withdrawn, notes an article in Frontline Medical News. The highest rates of relapse were among those with auditory hallucinations, where 78 percent of the group relapsed.
“I think the clinical impact we see here is that for patients with hallucinations, and particularly auditory hallucinations, antipsychotic discontinuation should be done very, very cautiously because they do have a very high risk of relapse,” said Anjali Patel, DO, of Columbia University, in a session presentation at the Alzheimer’s Association International Conference. “Close monitoring will be necessary and antipsychotic medications promptly reinstated if relapse occurs.”