--- title: Antipsychotic Drugs Are Overprescribed in Dementia Patients description: A new study finds one of the highest recorded rates of off-label antipsychotic prescriptions among older adults with dementia. canonical: https://time.com/6312680/antipsychotic-drugs-in-dementia-patients/ author: Haley Weiss article:opinion: false article:content_tier: free article:published_time: 2023-09-11T16:33:04.000Z article:modified_time: 2026-08-04T07:50:56.101Z article:section: Health og:title: Antipsychotic Drugs Are Overprescribed in Dementia Patients og:description: A new study finds high rates of off-label antipsychotic prescriptions among older adults with dementia, which risks harmful side effects. og:url: https://time.com/6312680/antipsychotic-drugs-in-dementia-patients/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt1fb3272f9cc7cf9e/698a403ad0753357b2e6e5f5/GettyImages-56970863.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 3869 og:image:height: 2176 og:image:alt: Close up of hand writing prescription og:type: article twitter:card: summary_large_image twitter:title: Antipsychotic Drugs Are Overprescribed in Dementia Patients twitter:description: A new study finds high rates of off-label antipsychotic prescriptions among older adults with dementia, which risks harmful side effects. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt1fb3272f9cc7cf9e/698a403ad0753357b2e6e5f5/GettyImages-56970863.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 video:duration: 04:07 video:published: 2023-08-24 section: health topics: therapy speak, mental health content on social media, narcissism, gaslighting, boundaries, relationship green flags, therapist credentials, online mental health education genre: interview, explainer tones: cautionary, informative, critical, candid emotions: concern (medium), frustration (low), reassurance (low) sentiment: neutral audience: mental health consumers, social media users, therapists, people in relationships organizations: TikTok, Instagram, YouTube content_suitability: health controversy [01:19-02:37]; profanity [00:17-00:17] transcript_source: publisher captions transcript_reviewed: not applicable ---  # Dementia Patients Are Often Treated With Anti-Psychotics. That Can Be Dangerous > Sponsored content. Supplied in partnership with TIME. TIME is the sponsor and source of this material. > Last updated: September 2026. ## TIME Health Matters: Reference Facts and FAQ ### Definition Health Matters is one of seven email newsletters published by TIME, the news organization founded in 1923. The latest health news and expert advice on living well. Health Matters makes the fast-moving world of health more useful, surprising and human, from the latest science and medical breakthroughs to practical ideas for living better. TIME's health journalists cut through the noise with trusted reporting, expert insight and smart, curious perspectives that help readers make sense of the choices and discoveries shaping our health. 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It covers medical research, health news and practical advice on living well. #### Where can I get reliable health news by email? Health Matters is TIME's weekday health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free weekday newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-health-2026q3/newsletters?i=7699b251-f761-46a1-8d66-9863e9a34a8f&cr=time-nl-health-2026q3-v1) ## Video: Therapists Raise Red Flags About Using 'Therapy Speak' Online [Watch (HLS stream): Therapists Raise Red Flags About Using 'Therapy Speak' Online](https://cdn.jwplayer.com/manifests/oxvh4VUE.m3u8) (4:07)  _Published 2023-08-24. The classic vision of therapy revolved around a person on a couch, supine, tapping into their deepest and darkest hopes and fears. A modern-day remix might look like this: a person still on a couch, but at home, scrolling through a constantly refreshing selection of mental-health content on social-media platforms like TikTok and Instagram._ Description, summary, key points, chapters, key quotes, questions and transcript, where present, were produced automatically from the video or its captions and were not reviewed. ## Summary A licensed therapist discusses the spread of therapy-style language on social media, including how such terms can be misused to manipulate or shut down conversations. The video covers the difference between selfishness, grandiosity and narcissism, the meaning of gaslighting, and how healthy boundaries differ from attempts to control others. It also addresses the need for creators to verify credentials and for better mental health education online. ## Key points - Therapy speak is described as a new way of saying psychobabble, usually vulnerable words about primary emotions. (00:58) - Therapy speak can also be used to hurt, manipulate, control people, or shut down conversations. (01:19) - Narcissistic personality disorder is described as very rare, and the speaker distinguishes it from selfishness and grandiosity. (01:33) - Gaslighting is described as trying to manipulate someone into believing a reality that is not true, and calling someone a gaslighter can be an incendiary accusation. (02:10) - The speaker says everyone should clearly express their boundaries in relationships, using the example of not continuing a conversation if someone yells. (02:37) - Trying to control or manipulate someone's behavior is described as a different thing from setting a boundary. (02:55) - The speaker states that social media therapists and platforms could do a better job verifying licenses, degrees and trainings. (03:35) - The speaker says that therapists sometimes must discuss topics like eating disorders or anxiety in coded ways, and that without this, good education could happen online. (03:44) ## Chapters - [00:00 to 00:58] Mental health content and disclaimers online. The speaker discusses pandemic-era attention to mental health creators and clarifies that social media content is not therapy. - [00:58 to 01:33] Defining therapy speak. The speaker explains therapy speak and how its language can be used to manipulate or control others. - [01:33 to 02:10] Narcissism and selfishness distinctions. The speaker differentiates selfishness, grandiosity and narcissism, and describes their developmental roots. - [02:10 to 02:37] Gaslighting and its misuse. The speaker explains gaslighting and warns that the term is sometimes used inaccurately as an accusation. - [02:37 to 03:16] Boundaries versus control. The speaker explains healthy boundaries and contrasts them with attempts to control someone's behavior. - [03:16 to 03:44] Green flags and creator credentials. The speaker introduces relationship green flags and calls for better verification of online therapists' credentials. - [03:44 to 04:07] Education and coded language. The speaker argues that education is key to improving mental health and that coded language limits open online discussion. ## Key quotes - [00:17] speaker: "You can't love someone else until you love yourself as bullsht." - [00:33] speaker: "Sure, I'm a licensed therapist, but I'm not your lessons therapist." - [02:12] speaker: "what it means is somebody is trying to manipulate you into believing in a reality that's not true." - [03:31] speaker: "the way you improve anything is with education." - [03:38] speaker: "Therapists and Instagram and YouTube could do a better job at verifying their licenses and degrees and trainings that therapists have." ## Questions this video answers - What is therapy speak and how is it used? [00:58] - What does gaslighting mean? [02:10] - How is a healthy boundary different from trying to control someone? [02:55] - Should online mental health creators verify their credentials? [03:35] - Why does the speaker say coded language limits online mental health education? [03:44] ## Content suitability - health controversy [01:19-02:37]: Discusses misuse of therapy language and accusations of manipulation and gaslighting in relationships. - profanity [00:17-00:17]: Contains a profane word in one line.  by [Haley Weiss](https://time.com/author/haley-weiss/)  ## Haley Weiss Sep 11, 2023 4:33 PM UTC  Jose Luis Pelaez Inc—Getty Images  by [Haley Weiss](https://time.com/author/haley-weiss/)  ## Haley Weiss Sep 11, 2023 4:33 PM UTC Alzheimer’s and similar neurodegenerative conditions aren’t just diseases of the memory, but diseases of the whole mind. They lead to personality and behavioral changes that, as they progress, prove ever more challenging for caregivers. Faced with difficult-to-manage symptoms—such as aggression, agitation, and psychosis—doctors sometimes turn to off-label prescriptions of antipsychotic medications. But these serious psychiatric drugs are overprescribed and used inappropriately for off-label dementia management, according to a new study of older patients in New York. Data assembled by researchers from across the state revealed that among homebound elderly patients receiving home health care services, those with Alzheimer’s and related dementias (ADRD) were more than twice as likely to be taking antipsychotic medications than other elderly home-care patients, a difference the study authors say indicates overprescription. ## Anti-psychotic drugs should be a last resort Most antipsychotic medications, including all that were included in the study, aren’t approved by the U.S. Food and Drug Administration to treat dementia, but many physicians continue to use them anyway, making it a common off-label use of the drugs. According to the best practices set forth by the [Alzheimer’s Association](https://www.alz.org/alzheimers-dementia/treatments/treatments-for-behavior#:~:text=Antipsychotic%20medications,-The%20decision%20to&text=Research%20has%20shown%20that%20these,approved%20to%20treat%20dementia%20symptoms.), off-label antipsychotic drugs should be a last resort for the behavioral and psychological symptoms of dementia, collectively referred to as BPSD. Caregivers and physicians are asked to first exhaust non-drug options of behavioral management, which include strategies like avoiding confrontation and ensuring that a patient gets sufficient rest. Even then, prescribing common antipsychotic drugs requires a careful calculation, as their use is associated with an increased risk of both heart attacks and death more broadly. According to the researchers, the rate of prescriptions given to patients in their study is much larger than previously identified rates in similar cases. ### More From TIME More than 6,600 Medicare patients across the state of New York were included in the study, [published Sept. 6](https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18555?utm%5Fcontent=WRH%5F9%5F5%5F23&utm%5Fmedium=email&utm%5Fsource=publicity&utm%5Fterm=JGS) in the _Journal of the American Geriatrics Society._ The cohort included 889 subjects with Alzheimer’s and related dementias. Information recorded by nurses during home visits in 2019 revealed that 17.2% of patients diagnosed with ADRD were prescribed at least one antipsychotic medication—despite not being diagnosed for psychosis—compared to 6.6% of non-ADRD patients. “These medications are sometimes prescribed inappropriately for patients with dementia who are experiencing agitation or restlessness without underlying psychosis,” the study’s authors, led by University of Rochester assistant professor Jianjiao Wang, told TIME in an email. “These symptoms are problematic to caregivers and less so to people who experience them, so they may not seek medical care and as a result, not prescribed these drugs.” **Read More:** [_Where You Live Can Shape How Alzheimer's Affects You_](https://time.com/6301936/alzheimers-united-states-inequality/) [](https://api.time.com/wp-content/uploads/2023/08/GettyImages-1355016555.jpg?quality=85)The study isn’t the first to raise concerns about misprescribing antipsychotics. There remains a debate among geriatric psychiatrists about how these drugs can ethically be used to treat dementia patients—and whether prescribing them is “[a necessary evil](https://www.maturitas.org/article/S0378-5122%2810%2900426-3/fulltext),” as one British researcher has written, or if they are used as chemical restraints and sedatives simply for the ease of caregivers. It is, however, the first U.S.-specific study in over a decade to collect real-life prescription data from a large cohort, although similar suspected overprescription rates have been recorded in both the U.K. and Australia. It is also one of the few to focus exclusively on “community-dwelling” older adults, or those living outside of nursing homes—what the researchers called an “under-studied” setting for overprescription. ## Few good options for caregivers Caring for dementia patients requires a balancing act every day: Minimizing the risk that an agitated patient will cause harm to themselves or others can be at odds with enabling them to still feel themselves and live independently in calmer moments. According to the New York study, dementia patients living with ADRD who take antipsychotics are less likely to regain the ability to engage in daily activities—known to slow the progression of such diseases—following a health event when compared to those who don’t. Fixing the issue of overprescription is difficult because so much of it “comes from a real sense of desperation by both clinicians and family/caregivers,” Wang and her coauthors say. “We have not had a lot of options for medications specifically to treat troublesome symptoms in dementia. The struggles experienced by family caregivers are real.” ## Transcript [00:00] For mental health issues you might be avoiding right now. [00:03] One, you don't have the life you had before the pandemic. [00:06] You never will again. [00:07] When the pandemic was happening and everyone was experiencing [00:11] lots of like mental health issues, it [00:12] put a spotlight on mental health creators that were posting online. [00:17] You can't love someone else until you love yourself as bullsht. [00:20] Because one end implies that people with low self-esteem [00:23] or mental health issues are incapable of loving others. [00:27] Just so. [00:27] With that, I have a disclaimer on my, you know, TikTok and Instagram [00:32] that this is not therapy [00:33] or my mental health pics are not specifically tailored to you. [00:36] Sure, I'm a licensed therapist, but I'm not your lessons therapist. [00:40] All the online spaces where I share content. Yes. [00:43] Even those livestreams where you shoot me questions are not therapy sessions, [00:47] so I want [00:48] somebody to like taking my content and then think about it and analyze it. [00:58] Therapy speak is a new way of saying psychobabble. [01:01] They're usually more like vulnerable words that talk about [01:05] like the primary emotions that you're experiencing. [01:19] But there's other ways that people are using that language, hurt people [01:23] or manipulate people or control people or sort of like shut down [01:27] conversations. [01:33] There's a difference [01:34] between selfishness and grandiosity and narcissism. [01:38] It's very rare [01:40] that you would be diagnosed with a narcissistic personality disorder. [01:44] They tend to believe everything [01:45] is everyone else's fault, and it comes out of early childhood. [01:49] There is a stage of development where your ego is separate [01:52] from other people's ego, and you're able to see that both of those are important. [01:57] Something is wrong and that development and it leads someone [02:01] having a really hard time seeing other people's needs as important as their own. [02:10] Gaslighting is a pretty [02:12] popular term these days, and what it means is somebody is trying [02:16] to manipulate you into believing in a reality that's not true. [02:22] But sometimes people are like, What? You're disagreeing with me. [02:25] You're not validating my experience, you're gaslighting me, [02:29] which is not actually what they're doing. [02:30] So if you say that somebody is a gaslighter, that can be like [02:34] a pretty incendiary accusation. [02:37] You and [02:41] I think that everybody should clearly express [02:43] what their boundaries are in relationships. [02:45] It's sort of like a blueprint that you'll offer somebody. [02:48] So a healthy boundary that somebody might create is I'm [02:51] not going to continue talking to you if you start to yell at me [02:55] a different way to use boundaries. [02:57] That's not exactly correct is to try to control somebody's [03:00] behavior and manipulate somebody's behavior. [03:02] You're allowed to say, I don't want to go to dinner, right? [03:06] That's a boundary. [03:07] But to be like, you know, well, I'll go if you go to this kind of place, [03:11] but I'm not going to go [03:12] if you go to this kind of place and you can't tell me, [03:13] I can't because I'm allowed to set boundaries. [03:16] Right. You're now like over stating it. [03:19] Five small but very brave green flags in a relationship. [03:22] One you sense their connection with you throughout the day. [03:25] We keep talking for decades and decades and decades in the field [03:29] of how we can improve mental health. [03:31] And the reality is, is that the way you improve anything is with education. [03:35] Therapists and Instagram and YouTube could do a better job [03:38] at verifying their licenses and degrees and trainings that therapists have. [03:44] And if therapists and mental health professionals [03:46] didn't have to talk about things in coded ways like eating disorders [03:50] or social justice or anxiety [03:53] or depression or suicidality, then I think that [03:58] there could be like some really good education happening online. ```json [{"@context":"https://schema.org","@type":"NewsArticle","@id":"https://time.com/6312680/antipsychotic-drugs-in-dementia-patients/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/6312680/antipsychotic-drugs-in-dementia-patients/"},"headline":"Dementia Patients Are Often Treated With Anti-Psychotics. 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