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Antipsychotic drugs increase health risks in patients with dementia
Last reviewed: 02.07.2025
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In a recent study published in the British Medical Journal, researchers assessed the side effects associated with the use of antipsychotic drugs in people with dementia.
People diagnosed with dementia experience functional impairment and progressive cognitive decline. Some common psychological and behavioral symptoms of dementia include anxiety, depression, apathy, aggression, delirium, irritability, and psychosis.
To manage the psychological and behavioural symptoms of dementia, patients are often treated with antipsychotics. The UK National Institute for Health and Clinical Excellence currently recommends that antipsychotics should only be used when non-drug interventions have failed to alleviate the behavioural and psychological symptoms of dementia. However, there has been an increase in the use of antipsychotics during the recent coronavirus (COVID-19) pandemic, which has been attributed to lockdown measures and the unavailability of non-drug treatments.
In the UK, risperidone and haloperidol are the only antipsychotics approved for the treatment of behavioural or psychological symptoms of dementia. In 2003, the US Food and Drug Administration (FDA) highlighted the risks of stroke, transient ischemic attack and death associated with the use of risperidone in older people with dementia.
Numerous research reports have led to regulatory recommendations in the UK, US and Europe to reduce inappropriate prescribing of antipsychotics for the treatment of behavioural and psychological symptoms of dementia. To date, few studies have provided data on the association between prescribing antipsychotics to older people with dementia and the risks of multiple health conditions such as myocardial infarction, venous thromboembolism, ventricular arrhythmia and acute renal failure.
The current study examined the risk of adverse outcomes associated with antipsychotics in a large cohort of adults with dementia. Some adverse outcomes considered in this study included venous thromboembolism, stroke, heart failure, ventricular arrhythmia, fracture, myocardial infarction, pneumonia, and acute kidney injury.
Over 98% of the UK population are registered with NHS primary care. All relevant data were collected from electronic medical records held in the Clinical Practice Research Database (CPRD), which is linked to over 2,000 general practices. The CPRD includes the Aurum and GOLD databases, which can be considered broadly representative of the UK population.