Treatment of behavioral/psychological symptoms in Alzheimer's disease.
This review examines the evidence for the use of drugs as part of the treatment of depressive/psychotic symptoms and behavioral disturbances in persons with Alzheimer's disease. Although conventional antidepressants appear to relieve depressive symptoms in Alzheimer's disease patients, placebo seems equally effective. The use of most medications used to control psychotic symptoms and disturbed/disturbing behaviors in Alzheimer's disease is off-label and not strongly supported by randomized, placebo-controlled trials, especially for so-called agitation. For these reasons, trials of psychotropic drugs in Alzheimer's disease need a placebo condition in addition to active comparators and in the case of nondrug treatments, a sham treatment condition. Cholinesterase inhibiting drugs may reduce behavioral symptoms in addition to slowing cognitive decline. Selective (for brain region) GABA agonists seem to offer the greatest theoretical promise for reducing agitated behaviors not driven by depression or psychosis.
Weiner
M F
MF
University of Texas, Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., NC6.102, Dallas, Texas 75390-9070, USA. myron.weiner@utsouthwestern.edu