The Relationship Between Antipsychotic Treatment and Quality of Life for Patients With Dementia Living in Residential and Nursing Home Care Facilities
J Clin Psychiatry 2004;65(suppl 11):23-28
© Copyright 2014 Physicians Postgraduate Press, Inc.
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For any treatment, the impact on quality of life (QoL) is a key consideration. These issues are particularly
important in the pharmacologic management of behavioral and psychological symptoms in
patients with dementia (BPSD). Although these symptoms can be very distressing for some patients,
the overall relationship of the symptoms with QoL is far less clear. In addition, although antipsychotic
agents have moderate efficacy in the short- to medium-term management of these symptoms, it cannot
be assumed that symptom resolution automatically equates with improved QoL. This is of particular
concern in light of the adverse side effect profiles of many of these agents. Indeed, the only empirical
study in this area conducted to date indicated that antipsychotics are associated with a worse QoL for
nursing home patients. Unfortunately, none of the placebo-controlled trials of antipsychotics for the
treatment of BPSD have included formal QoL measures, although preliminary evidence indicates that
atypical antipsychotics such as quetiapine may result in QoL improvements. The inclusion of systematic
QoL measures in future clinical trials is imperative in order to provide evidence to enable the
clinician to make informed judgments regarding the potential benefits or risks of pharmacologic treatment
for individual patients. In addition, such information will facilitate a better understanding of the
likely factors that may contribute to the impact of treatment on QoL (e.g., side effects) and hence
enable physicians to make rational treatment choices between different pharmacologic agents.