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

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.”