Psychiatria pre prax 6/2007

THERAPEUTICAL APPROACHES IN BEHAVIORAL DISORDERS IN DEMENTIA

Behavioral disorders belong to clinical picture of all types of dementia. If they occur, it is necessary to secure a safety for patients and their surrounding, to find out a cause of the state and apply targeted treatment (removal of the cause). Main parts of the intervention are nonpharmacological actions including a cooperation with care givers. Pharmacotherapy is indicated only in cases of uncontrollable states of aggressiveness, difficult psychotic production, and anxious or depressive symptomatology in case nonpharmacological approaches fail. SSRI antidepressives or trazodone are suitable medications. The use of antipsychotics is controversial, it is always necessary to weight the benefit against harm. In Alzheimer type dementia cholinesterase inhibitors and memantin with a positive influence also on behavioral disorders are indicated.

Keywords: behavioral disorders, dementia, nonpharmacological treatment, pharmacotherapy, antipsychotics of 2nd generation, SSRI, care-giving