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Alternatives to antipsychotics

Your articles [about antipsychotics] raise important points about the prescription of antipsychotic drugs for people with dementia. But the assertion there is no other option is misguided.

GPs to be ranked on antipsychotic prescribing

What, if not antipsychotics

Antipsychotics are a potentially useful treatment for some of the 180,000 people with dementia. But they cause around 1,800 deaths and 1,600 cerebral or cardiac vascular adverse events per year. That is why the coalition Government has committed to cutting their use by two-thirds by November 2011. By following good practice around initiation and monitoring of medication, and by regular reviews of their use, significant reductions in prescribing can be achieved.

Prescribing drugs with the potential to do harm, before exhausting other avenues, would not be acceptable in any other branch of medical practice – and neither is it here.

From Alistair Burns, national clinical director for dementia, and Professor Steve Field, outgoing chair of RCGP