Treatment of Behavioural and Psychological Symptoms in Dementia

Noncognitive symptoms in dementia include many kinds of behavioural and psychological symptoms. Behavioural and psychological symptoms of dementia, BPSD, is quite common problem among individuals with dementia, and often difficult to manage. BPSD can lead to premature institutionalization and decreased quality of life for both the caregiver and the patient. The purpose of this paper is to review and describe the main characteristics of dementia and to get an overall view of the management and treatment of the behavioural and psychological problems in dementia. There is consensus about that the nonpharmacologic interventions should allways be tried first before starting any medication for BPSD. However, it is exactly the efficacy of nonpharmacologic interventions that lack the the scientific proof in long term; more controlled trials are needed. Pharmacotherapies are used frequently to treat BPSD. Pharmacologic interventions are necessary when nonpharmacologic strategies fail to reduce behavioral symptoms sufficiently. For the time being pharmacolocig treatment includes the use of cognitive enhancers, antipsychotics, antidepressants, anticonvultants, benzodiatzepines. Because of the many possible adverse effects, the medication should be chosen individually and with great care. There are still open questions and uncertaintes when it comes to the safety issues of using these pharmacotherapies in patients with dementia, specially the recent warnings of increase in cardiovascular events related atypical antipsychotics need to be more closely investigated