{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T07:21:42Z","timestamp":1793863302002,"version":"4.6.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2015,11,3]]},"abstract":"<jats:p>Background: Antipsychotics are often used to treat neuropsychiatric symptoms in dementia, but the evidence for effect is limited. Antipsychotics have been associated with increased risk of adverse events and mortality in patients with dementia, leading to safety regulations worldwide. Objective: To investigate time trends in use of antipsychotics and other psychotropic drugs in dementia care. Methods: The study included longitudinal data on all Danish residents \u226565 years. The study population was defined on January 1 of each year from 2000\u20132012. Data included prescriptions, discharge diagnoses, and somatic and psychiatric comorbidities. Multivariate time trend analyses of psychotropic drug use in patients with dementia within 4-year age bands were performed. Results: Overall, among patients with dementia the prevalence of antipsychotic drug use decreased from 31.3% in 2000 to 20.4% in 2012. The decreasing use of antipsychotics was accompanied by decreasing use of anxiolytics and hypnotics\/sedatives, but an increase in the use of antidepressants from 43.3% in 2000 to 53.8% in 2012. These changes were significant across almost all age groups. Treatment intensity among patients using antipsychotics increased as the annual median number of defined daily doses (DDD) increased from 33.3 to 42.0 DDD. Conclusions: The changing patterns of psychotropic drug use may be caused by warnings against use of antipsychotics. Further research is needed to explore the implications for patient safety.<\/jats:p>","DOI":"10.3233\/jad-150481","type":"journal-article","created":{"date-parts":[[2015,11,3]],"date-time":"2015-11-03T11:25:00Z","timestamp":1446549900000},"page":"211-220","source":"Crossref","is-referenced-by-count":37,"title":["Time Trends in Antipsychotic Drug Use in Patients with Dementia: A Nationwide Study"],"prefix":"10.1177","volume":"49","author":[{"given":"Ane","family":"N\u00f8rgaard","sequence":"first","affiliation":[{"name":"Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Jensen-Dahm","sequence":"additional","affiliation":[{"name":"Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Gasse","sequence":"additional","affiliation":[{"name":"National Centre for Register Based Research, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne Vibe","family":"Hansen","sequence":"additional","affiliation":[{"name":"Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunhild","family":"Waldemar","sequence":"additional","affiliation":[{"name":"Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-150481_ref1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1017\/S1041610213001609","article-title":"The course of neuropsychiatric symptoms in nursing-home patients with dementia over a 53-month follow-up period","volume":"26","author":"Selbaek","year":"2014","journal-title":"Int Psychogeriatr"},{"key":"10.3233\/JAD-150481_ref2","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1001\/jama.287.16.2090","article-title":"Patient and caregiver characteristics and nursing home placement in patients with dementia","volume":"287","author":"Yaffe","year":"2002","journal-title":"JAMA"},{"key":"10.3233\/JAD-150481_ref3","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1038\/nrn1926","article-title":"Neuroleptic drugs in dementia: Benefits and harm","volume":"7","author":"Ballard","year":"2006","journal-title":"Nat Rev Neurosci"},{"key":"10.3233\/JAD-150481_ref4","doi-asserted-by":"crossref","first-page":"775","DOI":"10.7326\/0003-4819-146-11-200706050-00006","article-title":"Antipsychotic drug use and mortality in older adults with dementia","volume":"146","author":"Gill","year":"2007","journal-title":"Ann Intern Med"},{"key":"10.3233\/JAD-150481_ref5","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1056\/NEJMoa052827","article-title":"Risk of death in elderly users of conventional vs. atypical antipsychotic medications","volume":"353","author":"Wang","year":"2005","journal-title":"N Engl J Med"},{"key":"10.3233\/JAD-150481_ref6","unstructured":"Alzheimer\u2019s Association (2011) Managing behavioral and psychological symptoms of dementia (BPSD)"},{"key":"10.3233\/JAD-150481_ref7","unstructured":"National Health Service 2006 NICE guidelines. Supporting people with dementia and their carers in health and social care Last modified October 2012"},{"key":"10.3233\/JAD-150481_ref8","unstructured":"FDA (2008) Information for Healthcare Professionals: Conventional Antipsychotics"},{"key":"10.3233\/JAD-150481_ref9","unstructured":"Banerjee S 2009 The use of antipsychotic medication for people with dementia: Time for action. A report for the Minister for Care Services"},{"key":"10.3233\/JAD-150481_ref10","unstructured":"Danish Health Medicines, Authority (2004) Danish Health and Medicines Authority: Indsk\u00e6rper landets l\u00e6ger at udvise stor forsigtighed ved behandling med atypiske antipsykotika til \u00e6ldre patienter med demens. [Danish]"},{"key":"10.3233\/JAD-150481_ref11","unstructured":"Institute For Rational Pharmacotherapy (2008) Ny advarsel for antipsykotika [Danish]"},{"key":"10.3233\/JAD-150481_ref12","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.jalz.2011.08.004","article-title":"Impact of the Food and Drug Administration\u2019s antipsychotic black box warning on psychotropic drug prescribing in elderly patients with dementia in outpatient and office-based settings","volume":"8","author":"Desai","year":"2012","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-150481_ref13","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.euroneuro.2013.09.003","article-title":"Trends in use of antipsychotics in elderly patients with dementia: Impact of national safety warnings","volume":"24","author":"Gallini","year":"2014","journal-title":"Eur Neuropsychopharmacol"},{"key":"10.3233\/JAD-150481_ref14","doi-asserted-by":"crossref","first-page":"e68976","DOI":"10.1371\/journal.pone.0068976","article-title":"Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: Segmented regression time series analysis 2001-2011","volume":"8","author":"Guthrie","year":"2013","journal-title":"PLoS One"},{"key":"10.3233\/JAD-150481_ref15","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1177\/1403494811399956","article-title":"Introduction to Danish (nationwide) registers on health and social issues: Structure, access, legislation, and archiving","volume":"39","author":"Thygesen","year":"2011","journal-title":"Scand J Public Health"},{"key":"10.3233\/JAD-150481_ref16","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1403494811401482","article-title":"The danish national patient register","volume":"39","author":"Lynge","year":"2011","journal-title":"Scand J Public Health"},{"key":"10.3233\/JAD-150481_ref17","first-page":"82","article-title":"The danish psychiatric central register","volume":"44","author":"Munk-Jorgensen","year":"1997","journal-title":"Dan Med Bull"},{"key":"10.3233\/JAD-150481_ref18","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1177\/1403494810394717","article-title":"The danish national prescription registry","volume":"39","author":"Kildemoes","year":"2011","journal-title":"Scand J Public Health"},{"key":"10.3233\/JAD-150481_ref19","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1159\/000345485","article-title":"Overdiagnosis of dementia in young patients - a nationwide register-based study","volume":"34","author":"Salem","year":"2012","journal-title":"Dement Geriatr Cogn Disord"},{"key":"10.3233\/JAD-150481_ref21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1517\/14740338.2010.506711","article-title":"Atypical antipsychotics for the treatment of behavioral and psychological symptoms in dementia, with a particular focus on longer term outcomes and mortality","volume":"10","author":"Ballard","year":"2011","journal-title":"Expert Opin Drug Saf"},{"key":"10.3233\/JAD-150481_ref22","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.jclinepi.2004.03.012","article-title":"New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality","volume":"57","author":"Sundararajan","year":"2004","journal-title":"J Clin Epidemiol"},{"key":"10.3233\/JAD-150481_ref23","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1176\/ps.62.10.pss6210_1207","article-title":"After the black box warning: Predictors of psychotropic treatment choices for older patients with dementia","volume":"62","author":"Kim","year":"2011","journal-title":"Psychiatr Serv"},{"key":"10.3233\/JAD-150481_ref24","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/JCP.0000000000000133","article-title":"Antipsychotic doses among community-dwelling persons with Alzheimer disease in Finland","volume":"34","author":"Taipale","year":"2014","journal-title":"J Clin Psychopharmacol"},{"key":"10.3233\/JAD-150481_ref25","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.euroneuro.2011.12.009","article-title":"Changes in trend of antipsychotics prescription in patients treated with cholinesterase inhibitors after warnings from Italian Medicines Agency. Results from the EPIFARM-Elderly Project","volume":"22","author":"Franchi","year":"2012","journal-title":"Eur Neuropsychopharmacol"},{"key":"10.3233\/JAD-150481_ref26","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s40264-013-0057-3","article-title":"The impact of direct healthcare professional communication on prescribing practice in the UK hospital setting: An interrupted time series analysis","volume":"36","author":"Thomas","year":"2013","journal-title":"Drug Saf"},{"key":"10.3233\/JAD-150481_ref27","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1046\/j.1365-2710.2002.00430.x","article-title":"Segmented regression analysis of interrupted time series studies in medication use research","volume":"27","author":"Wagner","year":"2002","journal-title":"J Clin Pharm Ther"},{"key":"10.3233\/JAD-150481_ref28","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.euroneuro.2013.02.001","article-title":"Impact of safety warnings on antipsychotic prescriptions in dementia: Nothing has changed but the years and the substances","volume":"23","author":"Schulze","year":"2013","journal-title":"Eur Neuropsychopharmacol"},{"key":"10.3233\/JAD-150481_ref29","doi-asserted-by":"crossref","first-page":"e002080","DOI":"10.1136\/bmjopen-2012-002080","article-title":"Trends in the prevalence of antipsychotic drug use among patients with Alzheimer\u2019s disease and other dementias including those treated with antidementia drugs in the community in the UK: A cohort study","volume":"3","author":"Martinez","year":"2013","journal-title":"BMJ Open"},{"key":"10.3233\/JAD-150481_ref30","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1016\/j.euroneuro.2014.10.004","article-title":"High prevalence of psychotropic drug use among persons with and without Alzheimers disease in Finnish nationwide cohort","volume":"24","author":"Taipale","year":"2014","journal-title":"Eur Neuropsychopharmacol"},{"key":"10.3233\/JAD-150481_ref31","unstructured":"Danish Health and Medicines Authority (2014) Danish Health and Medicines Authority: Vejledning om behandling med antipsykotiske l\u00e6gemidler til personer over 18 med psykotiske lidelser [Danish]"},{"key":"10.3233\/JAD-150481_ref32","unstructured":"Danish Health and Medicines Authority (2013) Danish Health and Medicines Authority: National klinisk retningslinje for udredning og behandling af demens. [Danish]"},{"key":"10.3233\/JAD-150481_ref33","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1056\/NEJMoa061240","article-title":"Effectiveness of atypical antipsychotic drugs in patients with Alzheimer\u2019s disease","volume":"355","author":"Schneider","year":"2006","journal-title":"N Engl J Med"},{"key":"10.3233\/JAD-150481_ref34","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1001\/archgenpsychiatry.2010.200","article-title":"Trends in antipsychotic use in dementia 1999-2007","volume":"68","author":"Kales","year":"2011","journal-title":"Arch Gen Psychiatry"},{"key":"10.3233\/JAD-150481_ref35","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1038\/nrneurol.2009.39","article-title":"Management of agitation and aggression associated with Alzheimer disease","volume":"5","author":"Ballard","year":"2009","journal-title":"Nat Rev Neurol"},{"key":"10.3233\/JAD-150481_ref36","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0140-6736(11)60830-1","article-title":"Sertraline or mirtazapine for depression in dementia (HTA-SADD): A randomised, multicentre, double-blind, placebo-controlled trial","volume":"378","author":"Banerjee","year":"2011","journal-title":"Lancet"},{"key":"10.3233\/JAD-150481_ref37","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1001\/jama.2014.93","article-title":"Effect of citalopram on agitation in Alzheimer disease: The CitAD randomized clinical trial","volume":"311","author":"Porsteinsson","year":"2014","journal-title":"JAMA"},{"key":"10.3233\/JAD-150481_ref38","first-page":"CD008191","article-title":"Antidepressants for agitation and psychosis in dementia","author":"Seitz","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"10.3233\/JAD-150481_ref39","doi-asserted-by":"crossref","first-page":"d4551","DOI":"10.1136\/bmj.d4551","article-title":"Antidepressant use and risk of adverse outcomes in older people: Population based cohort study","volume":"343","author":"Coupland","year":"2011","journal-title":"BMJ"},{"key":"10.3233\/JAD-150481_ref40","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1159\/000107084","article-title":"Validity of dementia diagnoses in the Danish hospital registers","volume":"24","author":"Phung","year":"2007","journal-title":"Dement Geriatr Cogn Disord"},{"key":"10.3233\/JAD-150481_ref41","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1159\/000269933","article-title":"Time trend in diagnosing dementia in secondary care","volume":"29","author":"Phung","year":"2010","journal-title":"Dement Geriatr Cogn Disord"}],"container-title":["Journal of Alzheimer's Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/JAD-150481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:01:22Z","timestamp":1777370482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/JAD-150481"}},"subtitle":[],"editor":[{"given":"Peter","family":"Nestor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2015,11,3]]},"references-count":40,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3233\/jad-150481","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11,3]]}}}