Dementia Part III: Prescription Options to Manage Symptoms
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|