Background: The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care in the most recent empirical studies on the treatment with antipsychotic treatment and relate it to directives and recommendations from national authorities.

Methods: The study included; two scoping review studies and two empirical studies. The scoping studies were review of published data in electronic databases as well as Swedish recommendations and directives in the area.

Results: The last decade, recommendations were developed regarding antipsychotic medication in Sweden, in the beginning overviewing to be more and more specific and restrictive. The scoping review showed that the treatment with antipsychotic drugs varied between 6%-38%, and was higher in younger older persons and those with moderate cognitive impairment and living in nursing homes for people with dementia. A trend of a decreased treatment with antipsychotics was seen over the last 15 years. The empirical studies showed that the medication with antipsychotics decreased from 23.5 % in 2001 to 12 % in 2007, for older people in general as well as for older people with dementia. In older people with dementia only, 10% were utilizing antipsychotic medication, with no difference between those in ordinary homes compared to those in nursing homes.

Conclusions: Directives from Swedish national authorities seems to have had an impact on antipsychotic medication in people with dementia. The treatment with antipsychotic medication decreased, while other psychotropic medication increased. National directives complemented with systematic follow-ups may possibly be even more effective.

Conclusion: Treatment with orexin suppressed phagocytosis and degradation of Aβ. Further investigation suggested that the effects of orexin may be mainly on, or mediated through actin. Further investigations concerning the effects of orexin antagonists may be able to offer new methods to arrest the progress of, or possibly treat, AD.