Antipsychotics such as risperidone, olanzapine or
quetiapine, the ones that in the US are commonly used in this setting,
do seem to help with certain types of behavioral symptoms.
In particular, agitation, delusions, and hallucinations.
Therefore, they can be used in targeted ways.
It's important, though, to remember that they can have fairly catastrophic side
effects, including strokes, potentially heart attacks, and
they are also associated with a higher risk of death.
Because of the latter, in the United States, use of antipsychotics in people
with dementia carries what is known a black box warning by the Food and
Drug Administration.
So the risk-benefit equation has to be very clear.
In fact, there are emerging options that are non-antipsychotic medications,
that we'll talk about in a moment, referring to some antidepressants.
On balance, therefore, antipsychotics should be used very uncommonly,
after other medical problems as causes of behavioral symptoms have been clearly
ruled out, and after non-medication therapies have been tried first.
If it appears that an emergency is present, and it's necessary to use these
antipsychotics, it's critical to try and discontinue them as soon as possible.