When should drug treatments be prescribed for people with dementia?

When should drug treatments be prescribed?

Non-drug approaches can be very effective in reducing changes in mood and behaviour. However in some cases they don’t help the person.

If the person's problems continue to cause them severe distress or put them or others at risk of physical harm, a doctor may need to prescribe medication. Even then, drugs should always be used alongside individualised support and non-drug approaches, based on the person’s needs.

If a doctor decides that a certain drug might be helpful, they should discuss this with the person where possible, and ideally also with their carer. They should explain which specific problems the drug is being used to treat and any risks associated with taking it.

Does the person with dementia have to consent to drug treatment?

If the person has the ability (known as ’mental capacity’) to do so, they must consent before they can be given the drug.

The only exception to this is if they are being treated under a relevant section of the Mental Health Act 1983, or the Mental Health (Northern Ireland) Order 1986. These allow treatment without consent in exceptional situations.

If the person does not have capacity to consent, the doctor will decide whether it is in their best interests to have the drug. The doctor should still involve the person as much as possible and talk to those close to them.

How is drug treatment monitored?

If the drug is prescribed, the doctor will then monitor how effective the treatment is over a limited period of weeks or months.

The person’s changes in mood and behaviour should be regularly assessed alongside any side effects.

The doctor will often begin by prescribing a small dose and gradually increasing this until the best balance of benefits and side effects is reached. However, if it doesn’t seem to have helped, the doctor may stop the drug and try prescribing a different one instead.

How are drugs taken?

Drugs should always be taken as prescribed by the doctor and be kept safe and secure to avoid accidental overdose.

A pharmacist should be able to advise on storing and taking drugs, including ways to help someone remember to take them at the right times. For some types of drugs, they might recommend a ‘dosette box’, which has compartments for different days and times.

If the person is struggling to swallow pills or capsules, it may be possible for them to take their drugs another way, such as in liquid form or a skin patch.

A person should never suddenly stop taking a drug they have been taking regularly without first checking with their doctor or pharmacist that it is safe to do so.

Why do drugs have multiple names?

All medicines have at least two names: a generic name, which identifies the active substance, and a trade name, which may vary depending on the company that makes it. For example, Risperdal is a trade name for the antipsychotic drug risperidone. This factsheet only uses generic names.