Pharmacological management of delusions associated with dementia

This article aims to review evidence on pharmacologic treatments for the management of delusional symptoms in elderly patients with dementia.

METHODS: We searched PubMed using the words 'delusion', 'dementia' and 'treatment' from January 2007 till November 2017.

RESULTS: Non-pharmacologic interventions are first-line treatment. Acetyl-cholinesterase inhibitors have shown conflicting results in the treatment of delusions in dementia patients. However, donepezil may be particularly useful in the treatment of psychotic symptoms in Lewy body dementia (LBD). Antipsychotics are reserved for the treatment of severe symptoms. The highest level of evidence exists for risperidone, followed by olanzapine and quetiapine. Clozapine and pimavenserine are therapeutic options for Parkinson disease dementia and LBD. The duration of antipsychotic treatment should not exceed 6 weeks as per the French recommendations (Agence nationale pour la sécurité du médicament) and 4 months as per the American psychiatric association recommendations. In the event of failure to respond to the aforementioned treatments or as an alternative, antidepressants, in particularly citalopram can be considered. There is not enough evidence to recommend melatonine for the treatment of delusions in dementia patients, although it has been shown to improve behavioral symptoms of dementia in general.

CONCLUSIONS: The choice of medication for the treatment of delusions in dementia patients should be tailored to each patient. The severity of the symptom and its related danger should be considered along with the patient's co-morbidities and the medication's potential adverse effect.

Medienart:

E-Artikel

Erscheinungsjahr:

2019

Erschienen:

2019

Enthalten in:

Zur Gesamtaufnahme - volume:17

Enthalten in:

Geriatrie et psychologie neuropsychiatrie du vieillissement - 17(2019), 3 vom: 01. Sept., Seite 317-326

Sprache:

Französisch

Weiterer Titel:

Prise en charge pharmacologique des idées délirantes associées à un syndrome démentiel

Beteiligte Personen:

Abou Kassm, Sandra [VerfasserIn]
Naja, Wadih [VerfasserIn]
Hoertel, Nicolas [VerfasserIn]
Limosin, Frédéric [VerfasserIn]

Links:

Volltext

Themen:

Acetylcholinesterase inhibitor
Antidepressant
Antidepressive Agents
Antipsychotic
Antipsychotic Agents
Cholinesterase Inhibitors
Delusion
Dementia
Journal Article
Neurodegenerative
Psychotropic
Psychotropic Drugs
Review

Anmerkungen:

Date Completed 31.01.2020

Date Revised 02.02.2021

published: Print

Citation Status MEDLINE

doi:

10.1684/pnv.2019.0813

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM300587163