Psychiatria pre prax 1/2019

Pharmacotherapy of Alzheimer disease and neuropsychiatric symptoms of dementia

Alzheimer disease is the most prevalent cause of dementia. A precise diagnosis is required for effective management. Cholinesterase inhibitors are used as first line therapy to provide modest symptomatic benefit in some patients, memantine appears to have modest benefits in patients with moderate to severe disease. Neuropsychiatric symptoms are common in dementia and contribute to nursing home admission and caregiver stress. Identifying the genesis of the abnormal behavior is critical, in order that nonpharmacologic therapies are preferred over medication. Symptomatic pharmacologic treatment includes antidepressants, antipsychotics, anxiolytics and other alternatives. The following review discusses risks and benefits of particular drugs.

Keywords: Alzheimer, dementia, cholinesterase inhibitors, memantine, antidepressants, antipsychotics