The impact of FDA's warning on the use of antipsychotics in clinical practice: a survey.

OBJECTIVES

Determine the influence of warnings from the Food and Drug Administration (FDA) regarding antipsychotic use for the management of dementia-related psychosis on clinical practice.

DESIGN/SETTINGS/PARTICIPANTS: A survey of health care professionals specializing in geriatrics was conducted with the use of a Web-based software program. The questions focused on practitioners' familiarity with recent FDA warnings, perceptions of their validity, and changes in antipsychotic use patterns. Sixty-five geriatric practitioners belonging to major national geriatric organizations completed the survey.

INTERVENTION

Responses were reviewed once the survey was closed, six weeks after Web posting.

MAIN OUTCOME MEASURE(S): Changes in prescribing practices for the management of dementia-related psychosis in light of the antipsychotic FDA warnings.

RESULTS

The majority of participants responded that they were "very familiar" with the FDA warnings. The results indicated that 68% of participants reported using antipsychotic medications in elderly patients with known cerebral/cardiovascular diseases. Forty-nine percent of participants reported that they changed the way they managed elderly patients with dementia-related psychosis based on this notification. The most commonly reported barriers for not taking into consideration the FDA warnings were: no alternative treatment available, lack of guidance, lack of evidence, and poor availability of data. The majority of participants reported the use of atypical antipsychotics more frequently than the typical antipsychotics.

CONCLUSIONS

Despite FDA warnings, antipsychotics are still being used for the management of dementia-related psychosis; management of behaviors associated with dementia either through drug therapy or nonpharmacologic interventions remains a challenge.