The Food and Drug Administration in May approved the first drug to treat agitation related to Alzheimer’s disease dementia. Patient advocates hailed the news, but prescribing the drug, an antipsychotic, may put long-term care clinicians in a bind.
The approval is an added indication for Rexulti (brexpiprazole), which is also used for treating schizophrenia. Clinical trial participants who took 2 mg or 3 mg daily showed a 31% greater reduction in the frequency of agitation symptoms.
Agitation related to dementia is among the most common causes for placement in skilled nursing facilities and is a quality of life issue for facility residents. Yet Centers for Medicare & Medicaid Services requirements to report antipsychotic use for treating Alzheimer’s symptoms can leave clinicians at risk of looking less responsible to consumers when the data is publicly reported. The issue has become more urgent as more facilities admit residents with behavioral health issues, and new medications that can benefit residents are approved.
CMS convened a technical expert panel to review the issue. In the meantime, providers likely will take caution when deciding to prescribe the recommended Rexulti dose of 2 mg, which can be increased to 3 mg.
From the July/August 2023 Issue of McKnight's Long-Term Care News
