Diagnosis Drift and Its Contribution to Polypharmacy.

Diagnoses of drug-treatable illnesses has drifted to include milder conditions than in the past. Treating them increases the number of drugs given a person, risking polypharmacy, especially in elderly people with multiple conditions. The adverse consequences of polypharmacy are increased costs, confusion when taking drugs, adverse drug events, intermittent adherence with adverse drug discontinuation effects, and unrecognized delayed adverse effects.

Approaches to Gradual Dose Reduction of Chronic Off-Label Antipsychotics Used for Behavioral and Psychological Symptoms of Dementia.

Objective: Little is known about how to best taper antipsychotics used in patients with dementia. To address this gap, we reviewed published antipsychotic discontinuation trials to summarize what is known about tapering strategies for antipsychotics used with older adults with dementia. We further developed pharmacokinetic-based gradual dose reduction (GDR) protocols based on antipsychotic half-lives.