title: Apathy in Dementia: Systematic Review of Recent Evidence on Pharmacological Treatments.
abstract: Increasing recognition that apathy is one of the most prevalent behavioral and psychological symptoms of dementia and causes substantial caregiver distress has led to trials evaluating psychosocial and pharmacological treatments of apathy in dementia. We evaluated evidence of the efficacy of pharmacotherapies for apathy in dementia from studies since 2013. Previously reported benefits of acetylcholinesterase inhibitors and memantine were not replicated in recent studies. Antidepressants had mixed results with positive effects for apathy shown only for agomelatine, while stimulants, analgesics, and oxytocin study results were inconclusive. For some approaches, such as antipsychotic review, positive effects were found only in combination with nonpharmacological approaches. Relatively few studies assessed apathy outcomes specifically, complicating interpretation of potentially positive treatment effects; none dissected outcomes for emotional, motivational and behavioral components of apathy. Better trial design and more detailed analysis are needed in order to evaluate outcomes of pharmacological treatments for apathy.
authors.affiliation: Dementia Collaborative Research Centre-Assessment and Better Care, School of Psychiatry, University of New South Wales Australia, Sydney, NSW, 2052, Australia.|Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Australia, Sydney, NSW, 2052, Australia.
authors.forename: Fleur
authors.initials: F
authors.lastname: Harrison
authors.affiliation: Dementia Collaborative Research Centre-Assessment and Better Care, School of Psychiatry, University of New South Wales Australia, Sydney, NSW, 2052, Australia.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Aerts
authors.affiliation: Dementia Collaborative Research Centre-Assessment and Better Care, School of Psychiatry, University of New South Wales Australia, Sydney, NSW, 2052, Australia. h.brodaty@unsw.edu.au.|Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Australia, Sydney, NSW, 2052, Australia. h.brodaty@unsw.edu.au.|Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, 2031, Australia. h.brodaty@unsw.edu.au.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D057565:Apathy / Q000187:drug effects*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology*; D015259:Dopamine Agents / Q000627:therapeutic use; D006801:Humans; D008559:Memantine / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D002800:Cholinesterase Inhibitors; D015259:Dopamine Agents; D008559:Memantine
keywords: Alzheimer’s disease; Apathy; BPSD; Dementia; Neuropsychiatric symptoms; Pharmacotherapy