Management of Behavioral and Psychological Symptoms of Dementia
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. 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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Antipsychotics and antidepressants remain the main medications for behavioral and psychological symptoms of dementia.
“Antipsychotics and antidepressants remain the main medications for BPSD.”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [21]
Controversial and limited evidence cannot adequately support the use of benzodiazepines, anticonvulsants, stimulants, or dextromethorphan/quinidine for behavioral and psychological symptoms of dementia.
“Controversial and limited evidence cannot adequately support the use of benzodiazepines, anticonvulsants stimulants, or dextromethorphan/quinidine.”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [21]
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Current and Future Treatments in Alzheimer Disease: An Update
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- Authors
- Bessey, L. J., & Walaszek, A.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Bessey, Laurel J.
- ORCID
- Walaszek, Art
- Venue
- Current Psychiatry Reports
- Published
- 2019-07-01
- Volume
- 21
- Issue
- 8
- Pages
- 66-66
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- OpenAlex
- W2954244209
- Semantic Scholar
- 8ab33596e383781d668773c0ac659d301b5253e5
- Cited by
- 288
- References
- 69
- Citations by year
- 2026: 32 · 2025: 41 · 2024: 49 · 2023: 45 · 2022: 58 · 2021: 43 · 2020: 16 · 2019: 1 · 2018: 2 · 2013: 1
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- behavioral and psychological symptoms of dementia, non-pharmacological treatment, pharmacotherapy, caregiver education, antipsychotic drugs, antidepressants, dextromethorphan/quinidine, benzodiazepines, antiepileptic drugs, pimavanserin, nootropic drugs, symptom assessment, management algorithm, individualized care
- MeSH terms
- Antidepressive Agents, Behavioral Symptoms, Dementia, Humans, Antipsychotic Agents, Caregivers
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