Therapeutic dilemma's: antipsychotics use for neuropsychiatric symptoms of dementia, delirium and insomnia and risk of falling in older adults, a clinical review
Abstrakt
Purpose: This clinical review summarizes the current evidence on the risks of antipsychotic-related falls in older adults, including aspects of pharmacokinetics and -dynamics to assist clinicians in (de)prescribing antipsychotics in older people. Findings: Antipsychotics are widely used for neuropsychiatric symptoms of dementia, delirium and insomnia in older adults despite off-label indications.
Antipsychotics increase the risk of falls due to anticholinergic and extrapyramidal effects, sedation, and cardio- and cerebrovascular adverse effects. Message: Consider deprescribing of antipsychotics in older adults at risk of or with falls if there is no current indication, or if safer alternatives are available, or if antipsychotics are prescribed for neuropsychiatric symptoms of dementia, insomnia, or delirium.