De-escalation of antipsychotic medications in an elderly patient with Alzheimer's dementia residing in an assisted living facility

Clinicians frequently encounter the use of antipsychotic medications in elderly patients with Alzheimer's dementia (AD). The use of these agents may be a concern since they are not approved by the Food and Drug Administration (FDA) for the treatment of AD and have been shown to increase mortality in the elderly population. This case report focuses on the gradual de-escalation of antipsychotic medications in an 80 year-old female with AD residing in an assisted living facility who was prescribed three antipsychotic medications to help manage behavioral and psychotic symptoms consistent with progressing AD. Following a request by the assisted living facility, a local family medicine practice assessed the resident's treatment regimen. A collaborative consultation between the family medicine practice's clinical pharmacist, the family medicine physician, and the health care providers at the assisted living facility resulted in the decision to gradually discontinue each antipsychotic agent at subsequent facility visits by the family medicine team.

Duke Scholars

Author Lorraine Stone Sease Family Medicine and Community Health, Family Medicine