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Current Psychiatry Reports
Published in: Current Psychiatry Reports 8/2019

01-08-2019 | Antipsychotics | Geriatric Disorders (JA Cheong, Section Editor)

Management of Behavioral and Psychological Symptoms of Dementia

Authors: Laurel J. Bessey, Art Walaszek

Published in: Current Psychiatry Reports | Issue 8/2019

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Abstract

Purpose of Review

We review non-pharmacological and pharmacological approaches to managing behavioral and psychological symptoms of dementia (BPSD). We examine methods for assessment and evidence for interventions, focusing on recent findings and innovations. Finally, we recommend an algorithm for management of BPSD.

Recent Findings

Training of formal caregivers is the most effective intervention for BPSD; other non-pharmacological interventions are also beneficial. Antidepressants and antipsychotics remain a mainstay of pharmacological treatment for BPSD. There is limited evidence supporting the use of stimulants, cognitive enhancers, dextromethorphan/quinidine, benzodiazepines, anticonvulsants, and pimavanserin.

Summary

The management of BPSD is highly individualized. Following thorough assessment, the initial step is addressing contributing medical problems. Non-pharmacological interventions should be tried prior to pharmacological interventions. Antipsychotics should be prescribed only when behaviors pose a significant safety risk or if the person with dementia is very distressed. New approaches will be needed to address an increasing population of people with dementia.
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Metadata
Title
Management of Behavioral and Psychological Symptoms of Dementia
Authors
Laurel J. Bessey
Art Walaszek
Publication date
01-08-2019
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 8/2019
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-019-1049-5

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