Neuropsychiatric symptoms, such as agitation and depression, are common and challenging to treat in people with dementia. There is often limited access to multidisciplinary care teams that are equipped to identify and treat underlying causes and little evidence on interventions that can reduce the severity and burden of symptoms. Due to these challenges, people with dementia may be prescribed medications such as antipsychotics to treat symptoms.

Choosing Wisely and international guidance recommends avoiding antipsychotics as first choice to treat these symptoms. Antipsychotics are powerful medications that offer limited or no benefit and can potentially cause harm.

Barriers to non-medication interventions
There are many complex barriers to implementing non-medication interventions such as perceived lack of effectiveness or inadequate staffing. Non-medication interventions are not always available in all communities, which may lead to psychotropic medication use.

How should practice change
Watt and an international group of clinician and patient coauthors suggest establishing interprofessional care teams, developing appropriateness criteria, educating care staff, and informing family and caregivers are potential strategies for improving uptake of non-medication interventions for treating neuropsychiatric symptoms.