[Pharmacologic therapies of BPSD: messages from psychiatrists]

Behavioral and psychological symptoms of dementia (BPSD) is the term defined as symptoms of disturbed perception, thought content, mood or behavior that frequently occur in patients with dementia. As BPSD can cause remarkable distress for both the patient and the caregiver, clinicians are required to treat the symptoms effectively. Before undertaking an intervention to BPSD, patients should be assessed in a detailed clinical interview to establish symptoms causing distress to the patient and/or caregiver. Initial intervention should focus on nonpharmacologic measures. However, pharmacologic intervention is necessary in many cases. There are many classes of medications to choose from for treating BPSD, but the evidence behind treatment is varied and confusing. Clinicians should discuss the potential risks and benefits of treatment with patients, and must ensure a balance between side effects and tolerability compared with clinical benefit and QOL. To provide medical care to the patients with dementia represents the comprehensive management of them, including differential diagnosis, treatment of BPSD and education of caregivers. Almost all of the patients with dementia develop BPSD during the course of the disease. As long as dementia is a neurological disorder, both neurologists and psychiatrists should work cooperatively in the treatment of dementia.