Approach to managing behavioural disturbances in dementia.
OBJECTIVE
To review practical evidence-based treatment of behavioural symptoms in dementia. SOURCES OF INFORMATION MEDLINE: Was searched from January 1966 to December 2004 and PsycINFO from January 1967 to December 2004 using the key words "BPSD" (behavioural and psychological symptoms of dementia) and "behavioral disturbances dementia." I also reviewed the bibliographies of recent review papers and original articles.


RESULTS
Family physicians who manage hospital inpatients and care for people in nursing homes are asked to prescribe medications for demented patients. This review discusses alternatives to drugs, indications for appropriate use of drugs, frequently encountered side effects of drugs, and considerations for those with neuroleptic sensitivity. I suggest an approach that employs a combination of behavioural, environmental, and pharmacologic interventions to address disruptive behaviour in patients with dementia.


CONCLUSIONS
Optimal treatment of behavioural disturbances in patients with dementia involves nonpharmacologic approaches and using medications with demonstrated efficacy. Pharmacologic treatment should target only those symptoms or behaviours that respond to medication. This approach minimizes unnecessary medication use and reduces adverse outcomes.
Omelan
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D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods; D003704:Dementia / Q000150:complications / Q000628:therapy*; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004777:Environment; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000209:etiology; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D000069348:Quetiapine Fumarate
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D011619:Psychotropic Drugs; D000069348:Quetiapine Fumarate