Refer to the Good practice guides before prescribing antipsychotics in people with dementia and/or delirium: Rationalisation of antipsychotics in people with dementia: -initiation of treatment and reduction and cessation of treatment An approximately 3-fold increased risk of cerebrovascular adverse events have been This will be achieved by measuring the degree to which prescribing of antipsychotics to patients aged 65 years and over is in line with current NICE guidance, and supporting the identification of patients where it may be appropriate to reduce or discontinue their antipsychotic prescription. Researchers found that a review protocol, based on National Institute for Health and Care Excellence (NICE) guidelines, reduced the use of antipsychotic drugs by dementia patients but led to deterioration of neuropsychiatric symptoms. However, when the protocol was used alongside a programme of social interaction and activities of the prescription of antipsychotics to people living with dementia. Based on this evidence, National Institute for Clinical Excellence (NICE) guidance has made clear that antipsychotics should be only used in the first instance as a last resort in severe cases or where there is the risk of harm to the patient or others. It is important for Standards for the project were adapted from NICE guidance NG97: 10. 1. Patients with BPSD will be offered assessment to identify possible causes of agitation and distress. NICE decision aid 10 is recommended for use with patients and carers to offer an explanation of the benefits and risks of antipsychotic use in dementia patients. antipsychotic drugs should be avoided in patients suspected of having dementia with Lewy bodies - in these patients, antipsychotics may precipitate irreversible parkinsonism, further disturb consciousness levels and induce an autonomic disturbance similar to neuroleptic malignant syndrome, and increase mortality rates 2-3 fold (3) Monitoring for the emergence of movement disorders. Tests which need to be done every 12 months may be carried out at the annual physical review. Clozapine. People taking clozapine are managed exclusively in secondary care. Clozapine can cause neutropenia or agranulocytosis, and frequent monitoring of the full blood count is required. guidance is adapted from NHS Scotland Polypharmacy Guidance 2018 and follows best practice recommendations for review of antipsychotic prescribing in dementia. Aim This guidance supports a rational approach for the review of antipsychotic prescribing in patients with dementia within NHS Lanarkshire hospitals, care homes and community settings. Encourage and enable people living with dementia to give their own views and opinions about their care If needed, use additional or modified ways of communicating (for example visual aids or simplified text) Consider using a structured tool to assess the likes and dislikes, routines and personal history of a person living with dementia regard to the current NICE guidance. This guidance makes clear that people with dementia should only be offered antipsychotics if they are severely distressed or there is an immediate risk of harm to the person or others. The NHS locally should be following NICE guidance and PCTs have a responsibility to ensure that this happens (Government Other antipsychotic drugs must be prescribed within the remit of the GMC (2008) and the NICE-SCI