Brain Neurorehabil.  2015 Mar;8(1):19-23. 10.12786/bn.2015.8.1.19.

Pharmacological Treatment of Dementia

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea. njpaik@snu.ac.kr

Abstract

Pharmacological interventions are critical in dementia treatment to prevent disease progression. In this review, we aim to summarize and discuss about the current developments and recommendations in the pharmacological treatment of dementia. Cholinesterase inhibitors have demonstrated efficacy for Alzheimer's disease, mixed pathology with vascular dementia and Parkinson's disease dementia. The comparison study revealed no difference between each cholinesterase inhibitors. A high incidence of side effects of cholinesterase inhibitors could lower compliance. In this case, changing to the other drug or trying a transdermal type could be the solution. Memantine, a N-methyl-D-aspartate receptor antagonist, has proven to improve function at moderate to severe dementia and for dementia with Lewy body. But there are still insufficient evidences for the combination of a cholinesterase inhibitors and memantine. Discontinuing medicine in moderate to severe dementia may lead to worsening of cognitive function. For this reason, improving patients' compliance is important and for drug selection we should consider the type of dementia, severity of cognitive impairment and side effects of each medicine. Noncognitive symptoms, behavioral and psychological symptoms of dementia (BPSD) are common and can dominate disease presentation. For depression, selective serotonin reuptake inhibitors could be effective. Atypical antipsychotics could be used for other neuropsychological symptoms such as agitation, aggression, delusions and hallucinations.

Keyword

alzheimer disease; cholinesterase inhibitors; dementia; vascular dementia

MeSH Terms

Aggression
Alzheimer Disease
Antipsychotic Agents
Behavioral Symptoms
Cholinesterase Inhibitors
Compliance
Delusions
Dementia*
Dementia, Vascular
Depression
Dihydroergotamine
Disease Progression
Hallucinations
Incidence
Lewy Bodies
Memantine
N-Methylaspartate
Parkinson Disease
Pathology
Serotonin Uptake Inhibitors
Antipsychotic Agents
Cholinesterase Inhibitors
Dihydroergotamine
Memantine
N-Methylaspartate
Serotonin Uptake Inhibitors

Cited by  2 articles

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HyunChul Youn, Hyun-Ghang Jeong
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Effect of Cognitive Improvement Programs for Mild Cognitive Impairment in Korean Elderly: A Meta-Analysis
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