The treatment of behavioural and psychological symptoms in dementia: pragmatic recommendations.
Psychogeriatrics
; 24(4): 968-982, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38638077
ABSTRACT
Behavioural and psychological symptoms of dementia (BPSD) are a clinical challenge for the lack of a sound taxonomy, frequent presentation with comorbid BPSD, lack of specific pharmacologic interventions, poor base of methodologically sound evidence with randomized clinical trials, contamination from the treatment of behavioural disturbances of young and adult psychiatric conditions, and small efficacy window of psychotropic drugs. We present here a treatment workflow based on a concept-driven literature review based on the notions that (i) the aetiology of BPSD can be mainly neurobiological (so-called 'primary' symptoms) or mainly environmental and functional ('secondary' symptoms) and that this drives treatment; (ii) the clinical efficacy of psychotropic drugs is driven by their specific profile of receptor affinity; (iii) drug treatment should follow the rules of 'start low-go slow, prescribe and revise'. This article argues in support of the distinction between primary and secondary BPSD, as well as their characteristics, which until now have been just sketchily described in the literature. It also offers comprehensive and pragmatic clinician-oriented recommendations for the treatment of BPSD.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Psicotrópicos
/
Demencia
Límite:
Aged
/
Humans
Idioma:
En
Revista:
Psychogeriatrics
Asunto de la revista:
GERIATRIA
/
PSICOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Suiza