[Use of antipsychotic drugs in a long-term care institution. Experiences with implementing clinical guidelines]

Anti-psychotic drugs (neuroleptics) are useful for treating psychoses. However, non-psychotic patients, particularly patients with a deviant behaviour pattern, are often also treated with anti-psychotic drugs. The drugs may induce serious side-effects and should only be used on strict indications and at the lowest possible dosage. In a nursing home for deaf people with additional handicaps we introduced clinical guidelines for the use of anti-psychotic drugs and recorded their use during a two-year period. We found there was a reduction in the number of patients taking anti-psychotic drugs (from 32/54 to 26/54, p = 0.03), as well as a decrease in dosage per user (from median 2.4 mg to 1.7 mg equivalents of haloperidol, p = 0.05). Both the number of patients who were given depot injections and the number of different anti-psychotic drugs per patient were reduced. We conclude that it is possible to reduce the use of anti-psychotic drugs in institutions where long-term care is provided for disabled people.