The history of antipsychotics in nursing homes is one piece of a much larger, more complex puzzle. In many ways, it reflects the virtues and limitations of the entire health care system and those who provide care. None of the issues related to the use of antipsychotics are specific to these medications or to nursing homes. After decades of effort to reduce unwarranted antipsychotics use, the current situation is still a work in progress. Many widely held assumptions and standard narratives, such as those about behavior, the place of medications in person-centered care, and the causes of inappropriate medication use are only partially correct. This second of 3 articles is not intended to discuss how to diagnose and manage behavior disorders or choose medications. Instead, it addresses the diverse perspectives and key players that have been involved and the results of their efforts. Ultimately, this will set the stage for specific recommendations (part 3) about learning from past efforts surrounding antipsychotics to identify more definitive and lasting improvements in the future.

疗养院抗精神病药物的历史只是一个更大、更复杂的谜题的一部分。在许多方面，它反映了整个医疗保健系统和提供医疗服务的人员的优点和局限性。与使用抗精神病药物相关的问题都不是这些药物或疗养院所特有的。经过几十年的努力来减少不必要的抗精神病药物的使用，目前的情况仍在进行中。许多广泛持有的假设和标准叙述，例如关于行为、药物在以人为本的护理中的地位以及不适当药物使用的原因的假设和标准叙述仅部分正确。这三篇文章中的第二篇无意讨论如何诊断和管理行为障碍或选择药物。相反，它讨论了所涉及的不同观点和关键参与者以及他们努力的结果。最终，这将为具体建议（第 3 部分）奠定基础，即从过去围绕抗精神病药物的努力中学习，以确定未来更明确和持久的改进。