Dementia is a common off-label use of antipsychotics. However, there are
neither controlled studies, nor theoretical grounds supporting their use, especially in the
treatment of behavioral disorder, where antipsychotics behave mainly as the “major
tranquillizers” they once were meant to be. On the other hand, antipsychotics pose
serious risks to elderly, fragile patients with dementia. As a result, treating dementia
with antipsychotics could be a case in point of an irrational use of drugs. The chapter
reviews untoward effects linked to antipsychotics when used in dementia and suggests
some guidelines to make its use less irrational.
Keywords: Akathisia, Alzheimer’s disease, Behavioral and psychological
symptoms of dementia (BPSD), Behavioral disorder, Cardiac arrhythmia,
Cerebrovascular disorder, Clozapine, Confabulation, Delirium, Dementia, Firstgeneration
antipsychotics- Haloperidol, Lewy body disease, Misidentification
syndrome, Mortality, Off-label, Olanzapine, Psychosis, Quetiapine, Rational use
of drugs, Risperidone, Second-generation antipsychotics, Tardive dyskinesia,
Vascular dementia, Venous thromboembolism.
