Drug therapy to treat Alzheimer’s Dementia should be considered a last resort and not a permanent solution. Medication only should be considered if there is an immediate threat to the patient or to others. If a drug treatment is being considered, it should be for specific symptoms as outlined below. It should begin with a low dosage and increase only if effective and necessary.
Medications should be reevaluated frequently for effectiveness and monitored for side effects of the treatment. If side effects appear, consider a dosage reduction or discontinuation before adding another medication to treat the side effects. If symptoms can be resolved, consider a gradual dose reduction at least every three to six months with the goal of discontinuing the drugs all together. If symptoms persist, consider alternative treatment and consult with a specialist.
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Medications used to Manage the Neuropsychiatric Symptoms Associated with Dementia |
Psychotic Symptoms
(Delusions,Hallucinations) |
Low dose, second-generation antipsychotic including
risperidone, aripiprazole or quetiapine |
|
Depressive Symptoms |
Antidepressants, such as escitalopram, mirtazapine
and bupropion |
|
Apathy |
Antidepressants like escitalopram, mirtazapine or
bupropion |
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Mania-like Behavioral Symptoms |
Mood stabilizers, which could include
divalproex sodium, lamotrigine and carbamazepine |
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Original post may be found on
alixaRX.com blog.
Guest Post by Dr. Albert Barber:
Dr. Barber is a Director of Pharmacy Services for
alixaRx, a national long-term care pharmacy. He is responsible for clinical education and works on regulatory affairs for
alixaRx. Previously he was Director of Pharmacy for Golden Living, a provider of long-term and post-acute care for residents needing skilled nursing and assisted living services. He currently serves as the clinical consultant pharmacist for Golden Living Kirtland, Ohio. Al also provides drug therapy consultations to seniors living in the community through his consulting practice, Clinical Rx Consulting. Primary areas of practice include: post-acute care, geriatrics, psychopharmacology, and pain management.
Al is a Past-President of the American Society of Consultant Pharmacists (ASCP). He also serves as national faculty for the APhA Medication Therapy Management Certificate Program.
Pedagogy offers several online continuing education courses for nurses and accredited courses for long term care administrators dealing with the management of dementia.
Dementia Diagnosis and Treatment for Administrators
Dementia Diagnosis and Treatment: An Overview
Diagnosing Dementia
Introduction to Dementia
Massage and Compassionate Touch® in Dementia Care
Problem Solving Strategies in Dementia Care
Treatment of Dementia
Click on each title to learn more.