Psychotropic Alternatives to Antipsychotic Medications in Treating Dementia Behaviors An Evidence-Based Practice Protocol

Antipsychotic medications pose a significant risk to older adult patients with dementia and are frequently prescribed as first line treatment for behaviors associated with dementia in skilled nursing facilities (SNFs). SNFs are often cited by the Centers for Medicare & Medicaid for inappropriate antipsychotic medication use. The purpose of the current article is to communicate an evidence -based practice (EBP) clinical protocol that can guide clinicians away from prescribing antipsychotic medications in the treatment of dementia behaviors. A literature review of 17 rigorous research studies was conducted to determine psychotropic risk and efficacy in treating dementia behaviors. An EBP clinical protocol establishing a hierarchy of psychotropic medications based on risk and efficacy was developed to guide clinicians away from the use of antipsychotic medications and toward the use of potentially safer and more efficacious psycho tropic medications in dementia treatment while offering flexibility for clinical judgment.