We know the problems of using antipsychotics, but we are the ones who have to try to care for people with dementia and the people who care for them.
I had a patient who was physically fit and had moderate dementia. He had been on anticholinergics for some time but they had made no appreciable difference to his continued functional decline.
He would get into his head that he wanted to go home to his mother. He would be off in all weathers and be picked up by the police. If his wife had physically restrained him, he would be violent. She had the support of community psychiatric nurse visits, but was distressed.
Giving the patient antipsychotics reduced his agitation and his desire to wander. Was it wrong to use them?
If he was in a home, where carers cannot physically restrain 'clients', what could I have said to them? 'Sorry, I can't prescribe antipsychotics; they might limit his life expectancy; you'll just have to cope.' Where is the humanity?
Where is the realism in this blanket condemnation of a therapy that is all we have to offer to help in some circumstances?
Will the academics who condemn its use volunteer to replace the wives, husbands and carers who are at the end of their tether and see how far they get on with their precious psychological therapies, with their superior knowledge that they wish to impart by 'training'?
Now we are to have targets. Will those imposing the targets be on hand to clear up the mess left by not using these drugs? Of course not.
A grassroots GP, Norfolk.