A recent report has revealed that approximately 25% of long-term care residents in Canada were administered potent antipsychotic drugs without a psychosis diagnosis during the 2024-2025 period. These medications, such as Haldol and Risperidone, are primarily utilized to manage symptoms like hallucinations in individuals with schizophrenia and can also be employed to address aggression in dementia patients.
According to the Canadian Institute for Health Information (CIHI), the misuse of these drugs can lead to severe consequences, including adverse reactions, cognitive decline, falls, and even fatalities. Despite national efforts to reduce unnecessary antipsychotic use, the latest CIHI data indicates that the issue persists at a concerning level.
The CIHI data shows that 24% of long-term care residents in Canada received antipsychotic drugs that may have been unnecessary, with rates varying from 20% in Ontario to 36% in New Brunswick. The national rate exceeded that of the United States, Australia, and Sweden.
Before the COVID-19 pandemic, many Canadian jurisdictions were focused on curbing inappropriate antipsychotic use in long-term care facilities. However, during the pandemic, priorities shifted, leading to staffing shortages, isolation measures, and disrupted services in nursing homes.
To address this issue, the Appropriate Use Coalition in Canada set a national target for long-term care homes to limit antipsychotic use to 15% or less. This reduction is crucial due to the potential side effects of these medications, such as movement disorders and increased risk of death and strokes.
Dr. Samir Sinha, a geriatrician, emphasized the importance of prescribing antipsychotics cautiously and suggested exploring alternative approaches to manage behaviors in dementia patients. He recommended regular medication reviews in long-term care homes to ensure appropriateness and dosage adjustments when necessary.
Roslyn Compton, executive director of Better LTC in Saskatoon, highlighted the need to consider alternative care models for individuals with dementia instead of relying solely on large nursing homes. She emphasized the importance of providing adequate support environments to prevent the indiscriminate use of antipsychotic medications.
