Rinsho Shinkeigaku (Clinical Neurology)

The 46th Annual Meeting of the Japanese Society of Neurology

New therapeutic strategies for behavioral and psychological symptoms of dementia

Manabu Ikeda, M.D.

Department of Neuropsychiatry, Ehime University School of Medicine

Interventional studies, with the aim of reducing the burden of care through drug or non-drug therapies of behavioral and psychological symptoms of dementia (BPSD), have been scarce. However, we are now able to do pharmacological management for BPSD with new drugs such as atypical neuroleptics, SSRIs, and cholinesterase inhibitors.
Delusions of theft are one of the most frequently observed BPSD in patients with AD. In addition, the delusions and ensuing aggression and anxiety are major factors that increase the burden of caregivers. Delusions of theft in patients with AD were eliminated or reduced with low-dose atypical neuroleptics (risperidone). This significantly reduced the burden of care overall for caregivers. New therapeutic strategies such as cholinesterase inhibitors for visual hallucinations in DLB and SSRIs for overeating and stereotyped behavior in FTLD might also remarkably reduce the burden of care for these patients.
For many dementia patients, there are still no drugs that offer a principal cure. It is, therefore, important to evaluate their BPSD correctly at the earliest possible time, so that the burden of caring can be reduced through appropriate drug treatment. This reduction is critical for the continuation of satisfactory at-home care and might contribute to the health economics.

(CLINICA NEUROL, 45: 861|863, 2005)
key words: dementia, behavioral and psychological symptoms of dementia (BPSD), Alzheimer's disease, dementia with Lewy bodies, frontotemporal lobar degeneration

(Received: 25-May-05)