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What to avoid

Before any of the medicines mentioned in this information sheet are prescribed, it is essential to ensure that the person with dementia is physically healthy, comfortable and well cared for.

Whenever possible, the person should be helped to lead an active life, with interesting and stimulating daily activities.  By minimising distress and agitation it is often possible to avoid the use of medicines altogether.

If, after a full assessment, it is decided that medication is necessary, it is important to remember that:

  • Medication/sedation of the person with dementia must be seen as a last resort, because of the many possible side effects.  BEHAVIOUR ASSESSMENT AND MANAGEMENT WITHOUT MEDICINES MUST BE THE FIRST LINE OF INTERVENTION.
  • Some of the drugs taken to control behavioural symptoms can be dangerous if accidentally taken in large quantities.  Make sure medicines are kept in a safe place.
  • NEVER, EVER ASSUME that any changes/deterioration in a person with dementia are due to the dementia or old age.  It can be side-effects, which can be rectified, or an illness that can be treated.  ALWAYS mention any changes or concerns to the clinic/doctor.
  • A medicine that has worked well does not always continue to be effective.  Dementia is a degenerative condition.  The chemistry and structure of the brain will change during the course of the illness.
  • If the person also has Parkinson’s disease, many of the medicines used for people with dementia may not be used with the Parkinson’s medication.
  • Where epilepsy is being treated with Carbamazepine (Tegretol), the Carbamazepine can affect the levels of the antipsychotics in Risperdal.
  • Etomine (Clothiapine) given to a person with dementia will increase both the confusion and agitation and Oxazepam (Serepax) will increase the disorientation and confusion.
  • If symptoms are difficult to control, the doctor may refer you to a specialist for further advice.
  • Some medicines need to be taken regularly to have an effect - for example, antidepressants.  Other medicines such as hypnotics or anxiety-relieving medicines may be more effective when taken on an 'as needed' basis.  This should only be done after discussion with the doctor.
  • Do not expect immediate results.  Benefits may take several weeks to appear, particularly with antidepressants, which can take two to three weeks to have an effect.
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