Dementia management under the microscope

Prescribing antipsychotics to dementia patients with challenging behaviour may achieve the desired result of reducing agitation, but not necessarily for the right reasons.

The results of a randomised controlled trial among 352 patients with moderate to severe dementia found that paracetamol was more effective at reducing behavioural disturbances than the far riskier and more expensive antipsychotics.1

Dementia patients may be manifesting pain through their behavioural symptoms because they are unable to express themselves in other ways. So pain management programs are more likely to be addressing the root cause of the problem, while antipsychotics most likely work because of their sedative effect, according to Alzheimer’s Australia research manager, Dr Chris Hatherly.

“In general, assessment and management of pain in people with dementia is poor, particularly in late stages of the disease where individuals are more likely to be in nursing