Treatment with neuroleptics

Purpose of Assessment

The assessment is initiated by the Swedish Government. The report addresses a wide range of issues on the use of neuroleptics, such as the indications for the use of neuroleptics, its effects in the treatment of patients with psychotic disorders, patterns of prescription, receptor mechanisms for neuroleptics, the importance of dosage and determining concentration for individualized treatment, the use of depot treatment, negative symptoms, adverse effects, treatment of psychotic patients without the use of neuroleptics, treatment of young patients and elderly, treatment of drug addicts, the costs and benefits of neuroleptics.

Methods

Systematic Review, Cost analysis.

Primary Data Collection

Randomized controlled studies are included in the areas where this is feasible. In other areas a wider range of studies were included.

Basis for selection of data; type of study included

MEDLINE, Psychlit, EMBASE, SWEDMED included. Drug companies have been contacted for additional studies.

Review process for the publication

Project group, SBU Board of Directors and Scientific Advisory Group, External review committee.

Content of report

Neuroleptic medications are effective in treating psychotic patients between 18 and 65 years of age. However, 30 percent of the prescriptions in Sweden are written on inappropriate indications. In particular, older people with dementia are overtreated with neuroleptics. Considering the potentially serious side effects, neuroleptic therapy should be reserved for patients with severe psychosis.