CompletedNot Applicable

Optimization of Deprescribing Antidepressants in Nursing Home Residents With Dementia

Denmark180 participantsStarted 2021-10-15

Plain-language summary

The effectiveness of psychotropic medication on behavioral and psychological symptoms in dementia (BPDS) is limited, while they are associated with a higher risk of morbidity and mortality. Non-pharmacological treatment of BPSD is advocated as treatment of first choice. However, many general practitioners (GPs) find it difficult to initiate deprescribing and when attempting to discontinue psychotropic drugs in nursing home residents, they can face substantial barriers both among nursing home staff and relatives. Therefore, the investigators have developed an intervention specifically aimed at increasing knowledge on deprescribing and improving communication and collaboration between GPs, nursing home staff, relatives and patients to optimize the pharmacological treatment of BPSD.

Who can participate

Age range72 Years

SexALL

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Inclusion Criteria: * ≥72 years old * Either have a diagnosis of dementia or have a severe cognitive impairment as judged by the GP * Are permanently living at the nursing home * Are prescribed at least one antidepressant with the following ATC-codes * Selective serotonin reuptake inhibitors (SSRIs): N06AB10 (Escitalopram); N06AB04 (Citalopram); N06AB08 (Fluvoxamin); N06AB03 (Fluoxetin); N06AB05 (Paroxetin); N06AB06 (Sertralin); * Serotonin-Norepinephrine Reuptake inhibitors (SNRIs): N06AX21 (Duloxetin); N06AX16 (Venlafaxin); * Tricyclic antidepressants (TCAs): N06AA09 (Amitriptylin); N06AA04 (Clomipramin); N06AA02 (Imipramin); N06AA10 (Nortriptylin); (Dosulepin); N06AA17 * Noradrenergic and specific serotonergic antidepressants (NaSSAs) / Atypical antidepressants N06AX03 (Mianserin); N06AX11 (Mirtazapin); * Monoamine oxidase inhibitors (MAOIs):N06AF01 (Isocarboxazid); * Noradrenaline reuptake inhibitor (NARI): N06AX18 (Reboxetin); * Other antidepressant with effect on the serotonin-system: N06AX26 (Vortioxetin); * Melatonin agonists: N06AX22 (Agomelatin); Exclusion Criteria: * They are under treatment of a psychiatrist. * They are enrolled in another psychopharmacological trial * There is a suspicion of a current clinical, major depression or suicidal behavior and intentions. * Receiving end-of-life care

What they're measuring

Reduction of antidepressant

Timeframe: Intervention period of three months for each patient.

Trial details

NCT IDNCT04985305

SponsorUniversity of Copenhagen

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2022-11-01