Pharmacologic management of the symptoms of dementia

Many patients with dementia have symptoms of depression and agitation in addition to the underlying cognitive impairment. These symptoms can be management problems for both the physician and the caregiver. In many cases, however, pharmacologic intervention is helpful. Even in dementia, depressive symptoms usually respond to antidepressant therapy. Neuroleptic medications are the drugs most commonly used to manage behavioral symptoms, such as agitation, suspiciousness, emotional lability, hostility and sleeplessness. A few studies have shown that ergoloid mesylates (Hydergine) can modestly improve cognitive function. Some experimental drugs also show promise in partially reversing the symptoms of intellectual decline.