The percentage of people diagnosed with dementia prescribed anti-psychotic medication should be minimised.

On rare occasions some people living with dementia may be prescribed antipsychotic medication if they are experiencing certain symptoms such as agitation, aggression and distress. This should only occur where care interventions and other targeted strategies have not been successful in reducing their distress and/or agitation. Such medication can help some people, but it can also have side-effects and should only be prescribed where other methods of managing symptoms have failed.
For extra information, evidence and best practice please scroll down to the bottom of the page.

Regional offerings

Dementia United

Working towards improving the quality of life for people living with dementia or caring for someone who has dementia, supporting people to live as independently as possible and providing access to services when needed.

National offerings

Alzheimer’s Society

The Alzheimer’s Society provides reliable and up to date information to help you with every aspect of living with dementia.
Telephone: National Dementia Helpline: 0300 222 1122. Open 9.00am. – 5.00pm. Monday to Friday & 10.00am. – 4.00pm. Saturday and Sunday.

Dementia Friendly Hospital Charter

The Dementia-Friendly Hospital Charter was launched in 2015 as the second phase of the Right Care initiative.The charter outlines the high level principles that a dementia-friendly hospital should provide, together with notes for self-assessment and recommended actions they could take to fulfil them. There has been a revised version as a result of COVID-19.

MSNAP Memory Assessment Service Standards

The Royal College of Psychiatrists have a national accreditation programme for Memory Services against key standards. The website outlines the standards and the process.

NHS England Dementia

Dementia is a key priority for both NHS England and the Government. NHS England's work includes:
  • Developing an access and waiting time standard for dementia, so people with dementia have equal access to diagnosis as for other conditions; setting the national average for an initial assessment
  • Achieving and maintaining the dementia diagnosis rate. NHS England agreed a national ambition for diagnosis rates that two thirds of the estimated number of people with dementia in England should have a diagnosis with appropriate post-diagnostic support
  • Post diagnostic care and support; as there has been substantial progress on diagnosis, NHS England will focus on improving post-diagnostic support
Other organisations and sectors are crucial to helping NHS England deliver improvements to services for those with dementia and their carers. NHS England are working in collaboration with: Alzheimer’s Society, Public Health England, Department of Health, ADASS, Care UK, clinical commissioning groups, GP practices, Royal College of General Practitioners, Royal College of Psychiatrists, amongst other stakeholders to develop NHS England’s five year transformation plan for people with dementia.
NHS England have developed a Dementia Well Pathway which outlines standards across all aspects of the Pathway from prevention, diagnosing, supporting, living and dying well.
The NHS England dementia-well-pathway can be accessed here:
You can access the NHS England dementia programme of work here:

NICE Dementia Guidance

This guideline brings together all the research and evidence which covers assessment, diagnosis, treatment and support. It is for people at risk of developing dementia, people who are referred for assessment, people living with dementia as well as being for family and friends and health and social care staff and commissioners. It aims to improve care by making recommendations on standards people should expect to receive from their assessment, care and support as well as on training.
We have provided links to the NICE guideline for dementia and a further link is provided to guidance on how to delay or prevent the onset of dementia.
National Institute for Health and Clinical Excellence (NICE) NG16 (2015) Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset:
National Institute for Health and Clinical Excellence (NICE) (2019) Dementia: assessment, management and support for people living with dementia and their carers:

Redbag Scheme for Hospital Transfer From Care Homes and Back

This integrated pathway (Red Bag Pathway) is designed to support care homes, ambulance services and the local hospital meet the requirements of NICE guideline NG27: Transition between inpatient hospital setting and community or care homes. The red bag is used to transfer standardised paperwork, medication and personal belongings.


Healthwatch is your health and social care champion. If you use GPs and hospitals, dentists, pharmacies, care homes or other support services, we want to hear about your experiences. As an independent statutory body, we have the power to make sure NHS leaders and other decision makers listen to your feedback and improve standards of care. Last year we helped nearly a million people like you to have your say and get the information and advice you need.
Telephone: Call: 03000 683 000 between the hours of 08:30 – 17:30 Monday to Friday


Antipsychotic medicines for treating agitation, aggression and distress in people living with dementia: “The risks and limited benefits of using antipsychotics for managing agitation, aggression, distress, and psychosis in people living with dementia are well recognised and NICE recommends conducting a structured assessment to identify and address any underlying causes. A person living with dementia should only try an antipsychotic if they are at risk of harming themselves or others, or if they are severely distressed. The antipsychotic should be tried alongside other activities to try to help their distress. It should be used at the lowest dose that helps the person, and for the shortest possible time. The person should be assessed at least every 6 weeks and the antipsychotic should be stopped if it is not helping or is no longer needed.”

Royal College of Psychiatrists (2020) MSNAP Standards for Memory Services: “Patients who are prescribed antipsychotics have the appropriate physical health assessments at the start of treatment (baseline), and then every 3 months unless a physical health abnormality arises."

Research paper, Dementia prevention, intervention, and care, 2020 report of the Lancet Commission: “No new evidence of medication effectiveness for neuropsychiatric symptoms exists; risperidone in low doses (0·5 mg daily) and some other antipsychotics are sometimes effective but often ineffective and have adverse effects. Specific initiatives have led to a decrease in antipsychotic prescriptions for people with dementia, although often replaced with other psychotropics, such as benzodiazepines, antidepressants, and mood stabilisers.

These psychotropics lack evidence of efficacy for neuropsychiatric symptoms but show clear evidence of possible harm; for example, trazodone and benzodiazepines increase fall-related injuries. Major policy changes should be assessed carefully, within and across countries for unintended consequences (and perhaps unexpected benefits) and their costs...

Management of psychosis in dementia should start with non-pharmacological interventions; however, evidence for effectiveness of these interventions for psychosis in dementia is weaker than for agitation. Antipsychotics for psychosis in dementia should be prescribed in as low a dose and for the shortest duration possible. However, a Cochrane review of antipsychotics withdrawal found two trials with participants with dementia who had responded to antipsychotic treatment. These reported that stopping antipsychotics was associated with symptomatic relapse suggesting the need for caution in any medication withdrawal in this group.”

NICE guidance: "Adults with delirium in hospital or long-term care who are distressed or are a risk to themselves or others are not prescribed antipsychotic medication unless de-escalation techniques are ineffective or inappropriate. "

Research paper, Atypical antipsychotics benefit people with dementia but the risks of adverse events may outweigh the benefits, particularly with long term treatment: “Risperidone and olanzapine are useful in reducing aggression and risperidone reduces psychosis, but both are associated with serious adverse cerebrovascular events and extrapyramidal symptoms. Despite the modest efficacy, the significant increase in adverse events confirms that neither risperidone nor olanzapine should be used routinely to treat dementia patients with aggression or psychosis unless there is severe distress or risk of physical harm to those living and working with the patient.”

Best Practice Resources

Cookie Consent

We use Google Analytics to collect data and analyse our web traffic. This information allows us to understand user behaviour more accurately. We also share information about your use of our site with our analytics partner, who may combine it with other information that you have provided to them or that they have collected from your use of their services.

For more information on how Google uses the data collected via this service, see here.