Drug abuse? Use and misuse of psychotropic drugs in Alzheimer's care

Although psychotropic drugs are widely used to control symptoms related to dementia, concerns are raised by the potential for adverse effects and misuse. Antidepressants may be useful when depression and dementia coexist in the early stages of Alzheimer's disease. In later stages, anxiety and agitation are often treated with antianxiety or antipsychotic agents. Concerns escalate about the use of antipsychotic agents as chemical restraints. Nursing home reform provisions of OBRA '87 mandate dose reductions of antipsychotics in an effort to discontinue their use. The role of the nurse is to establish and monitor therapeutic goals, to assess the incidence and severity of predictable side effects, and to provide a safe, supportive environment that reduces the need for pharmacological intervention.