But it is VERY common for medications — especially antipsychotics — to be prescribed “off-label” for this purpose.
This is because people can experience increased anxiety plus discomfort due to physical withdrawal, and this often worsens their thinking and behavior.
Stopping benzodiazepines suddenly can provoke life-threatening withdrawal symptoms, so medical supervision is mandatory when reducing this type of medication.
: A 2014 randomized trial found that citalopram provided a modest improvement in neuropsychiatric symptoms; however the dose used was 30mg/day, which has since been discouraged by the FDA. These are the drugs FDA-approved to treat the memory and thinking problems associated with Alzheimer’s disease.
Otherwise clinical studies find that antidepressants are not effective for reducing agitation. In some patients they seem to help with certain neuropsychiatric symptoms.
: A review of randomized trials of valproate for agitation in dementia found no evidence of clinical efficacy, and described the rate of adverse effects as “unacceptable.” Despite this, some geriatric psychiatrists and other experts feel that valproate works well to improve behavior in certain people with dementia. SSRIs may help some individuals, but it usually takes weeks or longer to see an effect.
For some people, a sedating antidepressant at bedtime can improve sleep and this may reduce daytime irritability.This depends on the situation, but generally, the first choice to treat difficult behaviors is NOT medication.(A possible exception: geriatricians do often consider medication to treat pain or constipation, as these are common triggers for difficult behavior.) Instead, medications should be used after non-drug management approaches have been tried, or at least in combination with non-drug approaches.(See How You Can Help Someone Stop Ativan for more information.) : A recent review of clinical research concluded there is “limited evidence for clinical efficacy.” Although these drugs do have a noticeable effect when they are used, it’s not clear that they overall improve agitation and difficult behaviors in most people. These include medications otherwise used for seizures. However, they take weeks or even months to reach their full effect on depression or anxiety symptoms.It is also not clear that they work better than antipsychotics, for longer-term management of behavior problems. They generally reduce the “excitability” of brain cells. The effects of these medications on agitation is variable.Despite the risks of antipsychotics, family members are often anxious to get some relief as soon as possible.