Topic Overview
The decision to try medicine to treat behavior problems in
Alzheimer's disease is different for each person. The decision weighs the risks
and benefits of these medicines. Your doctor can help you decide. Medicines for
behavior problems linked to dementia do not work very well for most people and may have serious risks.
Medicines can be used to treat
behavior problems caused by
Alzheimer's disease and other diseases that cause
dementia. They should be used only after other nondrug
approaches have failed to improve a person's symptoms. Medicine may be needed
when the person is in danger of harming himself or herself or others or when
the caregiver is unable to deal with the situation using other means.
Antipsychotic medicines
Antipsychotic medicines may help relieve more
severe agitation or psychosis (disordered thought processes).
- Low doses may make the person more comfortable by
reducing certain symptoms, such as delusions, suspicion of others (paranoia),
hallucinations, hostility, or agitation.
- These medicines also may
improve sleep.
- The side effects may make some symptoms of
Alzheimer's disease worse, such as apathy, withdrawal from family and friends,
and inability to think clearly.
- These are powerful medicines. They
commonly cause dizziness, drowsiness, movement disorders that resemble
Parkinson's disease, low blood pressure upon standing (orthostatic
hypotension), and other side effects.
Examples of medicines sometimes used to treat hallucinations,
paranoia, and severe agitation in people who have dementia include aripiprazole, haloperidol, and risperidone.
FDA advisory. The U.S. Food and Drug
Administration (FDA) has issued an
advisory stating that people with dementia who use antipsychotics may
die sooner than those who don't use these drugs.
Antianxiety medicines
Antianxiety medicines, including minor
tranquilizers, relieve anxiety and mild agitation and may help calm the person.
But they can cause drowsiness if the dose is too high. When minor tranquilizers
are needed, short-term or occasional use often is better than continuous
use.
Lorazepam and oxazepam are minor tranquilizers
sometimes used to treat the symptoms of dementia. Another antianxiety medicine called
buspirone also can be tried.
- These medicines may increase confusion and upset
the person's balance. This raises the risk of falls.
- A person may
become dependent on these medicines over time, causing even worse symptoms when
he or she suddenly stops taking them. To avoid this problem, these drugs
usually are stopped gradually after a few weeks of use.
Anticonvulsant medicine
Anticonvulsant medicine, such as
valproic acid, may be used to control
agitation, violent behavior, and mood swings caused by dementia. But the U.S.
Food and Drug Administration (FDA) has not approved this medicine for this specific
problem.
The U.S. Food and Drug
Administration (FDA) has issued a warning on anticonvulsants and the risk of suicide and suicidal thoughts. The
FDA does not recommend that people stop using these medicines. Instead, people
who take anticonvulsant medicine should be watched closely for
warning signs of suicide. People who take
anticonvulsant medicine and who are worried about this side effect should talk
to a doctor.
Other medicines
Other medicines that may be used to treat agitation include antidepressants. Trazodone and serotonin reuptake inhibitors (SSRIs) such as citalopram, fluoxetine, and sertraline are examples. But research on the effectiveness of these
medicines in Alzheimer's disease and other dementias is limited.
The U.S. Food and Drug
Administration (FDA) has issued an
advisory on antidepressant medicines and the risk of
suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
See Drug Reference for more information about all of these
medicines. (Drug Reference is not available in all systems.)