October 22, 2025
Medications such as antipsychotics, antidepressants, and opioids that target the central nervous system (CNS) pose significant health risks for older adults with dementia, yet they remain widely prescribed. Few interventions have focused on helping this population safely discontinue such medications.
A new IMPACT-funded pilot study led by Elizabeth A. Phelan, MD, MS, tested the feasibility and acceptability of a deprescribing intervention in primary care.
Researchers conducted a one-arm pilot study across six primary care practices in an integrated healthcare system between February and August 2023 to test the feasibility and acceptability of a deprescribing intervention which combined patient and care partner education with provider decision support to encourage safer prescribing practices.
The study included 114 participants aged 60 and older with diagnosed dementia and at least one CNS-active prescription. The intervention was well received, earning an average acceptability rating of 3.5 out of 5. Notably, 44% of baseline antipsychotic users and more than half of tricyclic antidepressant users discontinued these medications by follow-up.
Rates of medically treated falls remained stable (22% at baseline vs. 21% at follow-up), suggesting the intervention did not increase fall risk.
Findings indicate that this deprescribing strategy is both feasible and acceptable and may meaningfully reduce unnecessary CNS-active medication use. The results support moving forward with a larger, controlled trial to evaluate clinical outcomes.
Read the full article here.