Antipsychotic use in nursing homes: response to the editorials by Dr. Morley and Dr. Volicer.

摘要

I read with interest the editorial debate published by Drs. Morley and Volicer and quite honestly it made me think back to my graduate coursework in pharmacology at University of Pennsylvania. It was there I learned, and repeat frequently to patients and students, "every drug is potentially good and potentially harmful." Moreover, epidemiologic outcomes do not hold true for every individual. What works for one individual may or may not work or may be harmful to another. The 2 editorials combined suggest that management of behavioral symptoms should be focused on prevention of symptoms to the degree possible, appropriate drug use and elimination or dose reduction of any currently prescribed drug. Both Drs. Morley and Volicer acknowledge that the physiological changes that occur with dementia put individuals at risk for behavioral symptoms and, because of chemical changes that occur as part of the disease process, may be best treated with pharmacologic management.