title: Time trends in antipsychotic drug use in patients with dementia: a nationwide study.
abstract: BACKGROUND
  Antipsychotics are often used to treat neuropsychiatric symptoms in dementia, but the evidence for effect is limited. Antipsychotics have been associated with increased risk of adverse events and mortality in patients with dementia, leading to safety regulations worldwide.
  
  
  OBJECTIVE
  To investigate time trends in use of antipsychotics and other psychotropic drugs in dementia care.
  
  
  METHODS
  The study included longitudinal data on all Danish residents ≥65 years. The study population was defined on January 1 of each year from 2000-2012. Data included prescriptions, discharge diagnoses, and somatic and psychiatric comorbidities. Multivariate time trend analyses of psychotropic drug use in patients with dementia within 4-year age bands were performed.
  
  
  RESULTS
  Overall, among patients with dementia the prevalence of antipsychotic drug use decreased from 31.3% in 2000 to 20.4% in 2012. The decreasing use of antipsychotics was accompanied by decreasing use of anxiolytics and hypnotics/sedatives, but an increase in the use of antidepressants from 43.3% in 2000 to 53.8% in 2012. These changes were significant across almost all age groups. Treatment intensity among patients using antipsychotics increased as the annual median number of defined daily doses (DDD) increased from 33.3 to 42.0 DDD.
  
  
  CONCLUSIONS
  The changing patterns of psychotropic drug use may be caused by warnings against use of antipsychotics. Further research is needed to explore the implications for patient safety.
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ane
authors.initials: A
authors.lastname: Nørgaard
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Jensen-Dahm
authors.affiliation: National Centre for Register Based Research, Aarhus University, Aarhus, Denmark.
authors.forename: Christiane
authors.initials: C
authors.lastname: Gasse
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Hanne Vibe
authors.initials: HV
authors.lastname: Hansen
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology; D003718:Denmark; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D012042:Registries
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives
keywords: Antidepressant drugs; antipsychotic drugs; dementia; neuropsychiatric symptoms; time trend