[The Adaptation of Anti-dementia Drugs for BPSD].

Abstract

In this article, I discuss the adaptation of antidementia drugs for Behavioral and Psycho- logical Symptoms of Dementia (BPSD). During the last few years, a large body of evidence has been accumulated to support the use of antidementia medication for BPSD in both Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) patients. On the selection of antidemen- tia drugs for BPSD, the following 3 factors should be considered : 1) the type of dementia the patients have (AD or DLB), 2) the type of drugs to be selected (cholinesterase inhibitors or memantine), and 3) the type of BPSD to be treated (such as delusions, hallucinations, agitation, and apathy). Cholinesterase inhibitors should be used for the treatment of people with DLB, especially BPSD. On the other hand, in AD patients with severe BPSD such as agitation and hallucinations, memantine should be initially considered. Pharmacological treatment of wander- ing and disinhibition in patients with dementia remains a challenge. As BPSD can cause marked distress for both the patient and caregiver, clinicians are required to treat the symptoms effectively. The consensus statement focuses on the fact that pharmacotherapy and psychological interventions can be effective both for cognitive dysfunc- tion and BPSD. Total care for BPSD involves the combination of pharmacotherapy with a non- pharmacological approach.