Off-label gebruik van medicatie voor de behandeling van deliri

The prescription of off-label medication, as is portrayed in the cases of Koopmans and Borst, can have benevolent effects on the patients. However, it is important to realize that these cases relate to a specific selection of patients and that extrapolation to the larger population of nursing home residents requires great caution. In case of serious adverse drug events, the prescription of off-label medication, for which little evidence of efficacy exists, can have major legal consequences for the prescribing physician. The prescription of the newer off-label medication like memantine or the cholinesterase inhibitors can therefore only be justified when pharmaceutical interventions advised by generally accepted guidelines have failed due to lack of effect or unacceptable adverse reactions.