In this article, I discuss the adaptation of antidementia drugs for Behavioral and Psychological Symptoms of Dementia (BPSD). During the last few years, a large body of evidence has been accumulated to support the use of antidementia medication for BPSD in both Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) patients. On the selection of antidementia drugs for BPSD, the following 3 factors should be considered: 1) the type of dementia the patients have (AD or DLB), 2) the type of drugs to be selected (cholinesterase inhibitors or memantine), and 3) the type of BPSD to be treated (such as delusions, hallucinations, agitation, and apathy). Cholinesterase inhibitors should be used for the treatment of people with DLB, especially BPSD. On the other hand, in AD patients with severe BPSD such as agitation and hallucinations, memantine should be initially considered. Pharmacological treatment of wandering and disinhibition in patients with dementia remains a challenge.
As BPSD can cause marked distress for both the patient and caregiver, clinicians are required to treat the symptoms effectively. The consensus statement focuses on the fact that pharmacotherapy and psychological interventions can be effective both for cognitive dysfunction and BPSD. Total care for BPSD involves the combination of pharmacotherapy with a nonpharmacological approach.
<Author's abstract>
The Adaptation of Anti-dementia Drugs for BPSD
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University
Psychiatria et Neurologia Japonica
118: 436-442, 2016
<Keywords:Alzheimer's disease, dementia with Lewy bodies, anti-dementia drug, BPSD>