Antipsychotics in LTC 

Antipsychotic Use in Canada

Antipsychotic medications should not be the first choice for managing dementia-related behaviours like aggression or resistance to care in long-term care (LTC) residents without a diagnosis of psychosis.

Despite long-standing Canadian guidelines cautioning against their use, one in four LTC residents in Canada are on antipsychotics potentially inappropriately, putting them at greater risk of serious harm. In comparison, this is nearly two and a half times higher than the reported 10% rate in the United States and well above the 18% in Australia and 15% in Sweden.

Setting a National Target

Concerned about the high rates of inappropriate antipsychotic use in Canada, an independent panel of experts was struck in 2024 to review current evidence in Canada and abroad, and to recommend a national target for how often these medications should be used. The panel reached full consensus on the following:

• Target for LTC Homes in Canada: The panel recommends 15% as the target for LTC homes in Canada for the quality indicator ‘potentially inappropriate use of antipsychotics in long-term care.’
• Annual Improvement Goal: For LTC homes that are not meeting the target for LTC homes in Canada, the panel recommends a 15% relative reduction as the annual improvement goal for the quality indicator ‘potentially inappropriate use of antipsychotics in long-term care.’

What Success Looks Like

Many LTC homes are already seeing success in reducing antipsychotic use. By adopting alternative, evidence-based approaches to manage behaviours, these homes are not only meeting the national target, but also improving the quality of care for their residents.