Antipsychotic drug prescribing to patients with dementia in a South African patient population

The primary aim of this study was to determine the prescribing pattern of antipsychotic drugs to patients with dementia in a South African patient population. A retrospective, cross-sectional drug utilisation study was conducted on 2010 prescription data of a national community pharmacy group. A total of 1231 patients were prescribed medication for dementia. The average age of patients was 75.10 (standard deviation (SD)=10.27) years, with 56.13% of female patients. A total of 5264 anti-dementia products were prescribed at an average cost of R584.06 per product. Donepezil accounted for 45.84% of prescriptions, followed by memantine (36.51%). Differences were observed between females and males with respect to the prescribing frequency of the different active ingredients ( 2 =48.491; d.f.=3; p<0.0001). Patients received on average 4.28 (SD=3.77) anti-dementia products over the year. Most patients (94.31%) received only one anti-dementia active ingredient during the year. Nearly a quarter of patients (23.23%) received one or more antipsychotic drugs despite “black box” warnings. Slightly more females were prescribed antipsychotic medication, with risperidone and quetiapine the most often prescribed antipsychotics. Older generation antipsychotics, such as haloperidol, were also prescribed. Despite warnings by health authorities, nearly a quarter of patients were prescribed antipsychotics. More comprehensive studies on antipsychotic use in dementia are needed to determine whether these drugs are used rationally and to ensure that the health of patients with dementia is not placed at risk.