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Antipsychotics in dementia — GPhC CRA MCQ

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ModerateAdverse Drug ReactionsAntipsychotics in dementiaGPhC CRA

A 82-year-old woman with dementia is brought to the pharmacy by her carer. She has been prescribed risperidone 500 micrograms twice daily for agitation. The carer asks about the risks. What is the most important risk to communicate?

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Correct answer: B — Antipsychotics in elderly patients with dementia are associated with an increased risk of stroke and mortality

The MHRA has issued safety warnings that antipsychotics, including risperidone, are associated with a small but significant increase in the risk of cerebrovascular events (stroke) and all-cause mortality when used in elderly patients with dementia. Risperidone is the only antipsychotic licensed for short-term use in persistent aggression in Alzheimer's dementia when non-pharmacological approaches have failed, but the risks must be clearly communicated.

Reference: BNF; MHRA Drug Safety Update; NICE NG97 Dementia