title: Impact of the Food and Drug Administration's antipsychotic black box warning on psychotropic drug prescribing in elderly patients with dementia in outpatient and office-based settings.
abstract: BACKGROUND
  Most patients with dementia also suffer from behavioral and psychological symptoms of dementia, for which there is no Food and Drug Administration-approved treatment.
  
  
  OBJECTIVE
  To determine whether the Food and Drug Administration's black box warning in April 2005 has led to a decline in prescriptions of atypical antipsychotics for behavioral and psychological symptoms of dementia, as well as whether prescriptions for other psychotropic drugs, including antidepressants, anxiolytics, and antiepileptics, as substitutes, have increased.
  
  
  METHODS
  Data on outpatient visits by elderly dementia patients were obtained from two large national surveys from 2003 to 2008. Any psychotropic drug mentions were identified. Percentage utilization statistics were calculated.
  
  
  RESULTS
  The percentage of visits mentioning an atypical antipsychotic decreased from 12.5% prewarning to 11.5% postwarning. Postwarning, 34.4% of patients were taking none of the study medications, as opposed to 26.1% prewarning.
  
  
  CONCLUSIONS
  After the warning, there was a small decline in the use of atypical antipsychotics and no evidence of substitution of other psychotropic medications.
authors.affiliation: Division of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of Cincinnati, OH, USA.
authors.forename: Vibha C A
authors.initials: VC
authors.lastname: Desai
authors.forename: Pamela C
authors.initials: PC
authors.lastname: Heaton
authors.forename: Christina M L
authors.initials: CM
authors.lastname: Kelton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy*; D004348:Drug Labeling; D005260:Female; D005853:Geriatrics; D006801:Humans; D008297:Male; D010045:Outpatients; D012308:Risk Management; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D014150:Antipsychotic Agents