Researchers at a major UK university report that antipsychotic drugs, commonly used to manage disruptive behaviours in dementia, may be linked with higher risks of several serious health problems. The study notes a connection to stroke, blood clots, heart attack, heart failure, falls-related fractures, pneumonia, and acute kidney injury. The findings were published in a leading medical journal, the British Medical Journal.
The researchers examined health records from 173,910 people living with dementia, with an average age near 82. Among this group, information from 35,339 patients showed that an antipsychotic medication was prescribed on the day dementia was diagnosed. Neuroleptics, another name for antipsychotics, are used to counteract delusions, hallucinations, and other psychotic symptoms. When chosen carefully, these medicines can support care and supervision for individuals with dementia, delirium, or related cognitive conditions, but their use must balance potential benefits with safety concerns.
The study identified that taking antipsychotics was associated with roughly a 1.7-fold increase in the risk of acute kidney injury and about a 1.6-fold rise in the risk of stroke and venous thromboembolism, which includes conditions like deep vein thrombosis and pulmonary embolism. The analysis suggests that early treatment phases carry added risk, highlighting the need for vigilant monitoring during the initial period of therapy.
Researchers further estimated that initiating antipsychotics during the first six months of treatment correlated with one additional pneumonia case for every nine patients and one additional heart attack for about every 167 individuals. There was also an observed link to higher chances of heart failure, additional heart events, and fractures resulting from falls. These estimates underscore the importance of individualized risk assessment and careful follow up for those taking these drugs as part of dementia care.
The study authors stressed that the research is observational, so it cannot prove that antipsychotics cause these problems. They noted that outcomes could be influenced by factors such as inaccuracies in documenting antipsychotic use or other uncontrolled variables. Clinicians are urged to weigh these potential risks against patient needs, preferences, and alternative strategies when deciding how to manage dementia-related behaviours. Shared decision making, ongoing evaluation, and non-drug approaches should be considered as part of a comprehensive care plan.
In a broader context, earlier discussions have explored diet and lifestyle approaches once proposed to slow memory decline in Alzheimer’s disease, illustrating how strategies for cognitive health evolve over time. This ongoing dialogue shapes guidance for healthcare providers as they strive to balance symptom control with safety in dementia care. The conversation influences how care plans are created for older adults in Canada, the United States, and across North America, reflecting a practical, patient-centered approach to treatment that keeps safety at the forefront.