Non-neuroleptic treatment of behavioral symptoms and agitation in Alzheimer's disease and other dementia.
Both neuroleptic and nonneuroleptic medications are widely used to treat symptomatic behaviors in dementia patients. There is a substantial body of literature suggesting that neuroleptics are modestly effective in treating these symptoms, but the magnitude of their effect is limited. Nonneuroleptic medications, such as anticonvulsants and antidepressants, have been advocated as useful in treating certain symptoms but have not been as well studied. This article critically reviews the published evidence for the effectiveness of selected nonneuroleptic medications in treating behavioral symptoms in elderly dementia patients, especially those with possible Alzheimer's disease (AD). The literature consists almost entirely of clinical series and case reports, making interpretations of the efficacy of individual medications difficult. With the singular exception of the serotonin uptake blocker citalopram, the few placebo-controlled studies are of small sample sizes, showing at best very modest efficacy for the study medication. Despite their widespread use, there is very little published, empirical evidence for the effectiveness of these agents for treating behavioral symptoms in elderly dementia patients.
Department of Psychiatry and the Behavioral Sciences, University of Southern California, School of Medicine, Los Angeles 90033.
L S
LS
Schneider
P B
PB
Sobin
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000544:Alzheimer Disease / Q000188:drug therapy*; D002065:Buspirone / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D014179:Neurotransmitter Uptake Inhibitors / Q000627:therapeutic use; D012642:Selegiline / Q000627:therapeutic use; D012701:Serotonin / Q000502:physiology; D014196:Trazodone / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D014179:Neurotransmitter Uptake Inhibitors; D012642:Selegiline; D012701:Serotonin; D002220:Carbamazepine; D008094:Lithium; D002065:Buspirone; D014196:Trazodone