[Pharmacological treatment in severe dementia].
Medical treatment of severe dementia is now available. Decrease of psychobehavioral disturbances, autonomy loss or care-giver burden appear as the main objective rather than reduction of cognitive deficits. Acetylcholinesterase inhibitors (AChE-I) should be maintained in patients with severe dementia when initiated in mild or moderate dementia. Memantine is the specific treatment for patients with severe dementia, even if they received AChE-I. To treat the psychobehavioral disturbancies, serotoninergic agents and thymoregulators are the first line drugs. Medical treatment should only be co-prescribed with a global care of all co-morbidities, autonomy loss and patient's and care-giver's burden, and associated with psychological and organisational support.
Jouanny
Pierre
P
Centre mémoire de ressource et de recherche, Université de Rennes I, France. pierre.jouanny@chu-rennes.fr
Belliard
Serge
S
Bentué-Ferrer
Danièle
D
Michel
Olivier
O
Allain
Hervé
H
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D017281:Cost of Illness; D004359:Drug Therapy, Combination; D015577:Geriatric Assessment; D006701:Home Nursing / Q000523:psychology; D006801:Humans; D008559:Memantine / Q000627:therapeutic use; D018697:Nootropic Agents / Q000627:therapeutic use*; D018490:Serotonin Agents / Q000627:therapeutic use
D000928:Antidepressive Agents; D002800:Cholinesterase Inhibitors; D018697:Nootropic Agents; D018490:Serotonin Agents; D008559:Memantine