The Pharmacological Approach of Behavioral Disturbances in Dementia

Behavioral and psychological symptoms in dementia (BPSD) are often overlooked due to the main focus of treating or preventing cognitive decline symptoms. Almost two-thirds of patients with dementia will develop some type of noncognitive symptoms that include symptoms such as wandering, agitation, sexually inappropriate behaviors, physical and verbal aggression, uncooperativeness, and “sun-downing.” Psychological symptoms include depression, anxiety, delusions, hallucinations, and suspiciousness/paranoia. Worsening of these symptoms can lead to caregiver burden and is one of the major reasons for patients with dementia to be institutionalized. A major drawback of treating these symptoms pharmacologically is that the response rate is low with the current available therapies such as antipsychotics, anxiolytics, and antidepressants. In addition, all of these therapeutic classes have drawbacks due to side effect profiles. This article provides an overview of the current recommendations for pharmacological appr...