SAMHSA has recently released a new brief, Guidance on Inappropriate Use of Antipsychotics: Older Adults and People with Intellectual and Developmental Disabilities in Community Settings. ACL staff provided guidance for the development of this brief.

The brief is intended primarily for physicians and other prescribers as well as support staff, administrators, and caregivers working with people with dementia and intellectual and developmental disabilities (IDD) in community settings. To reduce inappropriate prescribing, this brief reviews non-pharmacologic behavioral approaches and strategies to avoid and reduce prescribing of antipsychotics whenever possible.

Key messages:

Behavioral manifestations of dementia and IDD require careful assessment and management.Non-pharmacologic approaches to care should always be attempted first, including helping individuals maintain a routine schedule, avoiding demanding or challenging tasks, and focusing on creating a positive environment.If antipsychotics are required for behaviors that are dangerous to the individual or to caregivers, dosage should be started as low as possible with modest increases only when necessary, and medications should be discontinued through tapering if no clinical benefit is observed.