title: Safety and efficacy of antipsychotic drugs for the behavioral and psychological symptoms of dementia.
abstract: BACKGROUND
  Antipsychotic drugs are commonly used in the treatment of the behavioral and psychological symptoms of dementia (BPSD).
  
  
  METHODS
  We present a qualitative review of the data on the efficacy and safety of antipsychotic drugs for BPSD. We more specifically examine safety issues with an especial focus on recent research. We examine two safety studies in detail to provide readers with a critical perspective.
  
  
  RESULTS
  Typical and atypical antipsychotic drugs both attenuate the severity of BPSD; however, both categories of drugs increase the risk of cerebrovascular and other adverse events, as well as the risk of death. The risk appears greater with the typical drugs, with higher doses, and during the initial weeks of treatment. The risk probably persists for as long as a year after the initiation of treatment. Both drug- and patient-related factors appear to mediate this increase in risk.
  
  
  CONCLUSIONS
  Antipsychotic drugs should be considered for BPSD only if there is a specific need, or if other treatments have failed; decision-making should be individualized and documented after a risk-benefit analysis. Atypical antipsychotics appear safer than the typical drugs. The lowest effective dose should be used.
authors.affiliation: Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India.
authors.forename: Chittaranjan
authors.initials: C
authors.lastname: Andrade
authors.forename: Rajiv
authors.initials: R
authors.lastname: Radhakrishnan