Dementia Part III: Prescription Options to Manage Symptoms

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Drug therapy to treat Alzheimer’s Dementia should be considered a last resort and not a permanent solution. Medication only should be considered if there is an immediate threat to the patient or to others. If a drug treatment is being considered, it should be for specific symptoms as outlined below. It should begin with a low dosage and increase only if effective and necessary.

Medications should be reevaluated frequently for effectiveness and monitored for side effects of the treatment. If side effects appear, consider a dosage reduction or discontinuation before adding another medication to treat the side effects. If symptoms can be resolved, consider a gradual dose reduction at least every three to six months with the goal of discontinuing the drugs all together. If symptoms persist, consider alternative treatment and consult with a specialist.


Medications used to Manage the Neuropsychiatric Symptoms Associated with Dementia

Psychotic Symptoms(Delusions, Hallucinations) Low dose, second-generation antipsychotic including risperidone, aripiprazole or quetiapine 
Depressive Symptoms Antidepressants, such as escitalopram, mirtazapine and bupropion 
Apathy Antidepressants like escitalopram, mirtazapine or bupropion 
Mania-like Behavioral Symptoms Mood stabilizers, which could include divalproex sodium, lamotrigine and carbamazepine