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GP alert on dementia drugs

GPs have been warned patients with dementia must have regular medication reviews after researchers found psychiatrists were not giving clear guidance.

The use of antipsychotic drugs in older people with dementia can cause significant problems, including limb fractures, and experts recommend treatment is time-limited and its justification documented.But old-age psychiatrists are failing to communicate this to GPs, a study published in last month's Psychiatric Bulletin found.A review of discharge summaries and outpatient review letters about prescription of antipsychotic drugs for patients with dementia found most were 'below acceptable standards' and quality actually fell between 2002 and 2005.Study leader Dr Ayodeji Soyinka, specialist registrar in old-age psychiatry at St Mary's Hospital, Leeds, said antipsychotic drugs were 'very commonly used' but were 'potentially harmful'.'Consistent and clear information from secondary care is essential, and may have an influence on the GP's prescribing,' he said.GPs agreed that referral letters were key to good care.Dr Steve Iliffe, a GP in Kilburn, north London, and co-director of the Centre for Ageing Population Studies, said: 'The problem for GPs is that we don't really see enough people in this situation to be frequent prescribers, so guidance matters. 'It is getting increasingly confusing to know what is safe and what isn't.'Dr Iliffe said GPs should go back to old-age psychiatrists for advice if they were unsure about prescribing antipsy-chotics in dementia.

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