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Managing severe aggression in frontotemporal dementia.

Alice Powell1, Patrick Flynn, Sally Rischbieth

  • 1Psychiatry RMO, Older Persons Mental Health Services, Northern Adelaide Local Health Network, Adelaide, SA, Australia.

Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists
|November 2, 2013
PubMed
Summary
This summary is machine-generated.

Managing severe aggression in dementia is challenging, with limited safe treatment options. Haloperidol use in dementia patients is linked to increased mortality, highlighting critical care gaps.

Keywords:
aggressionbehavioural and psychological symptoms of dementia (BPSD)extra-pyramidal side effects (EPSE)frontotemporal dementiahaloperidol

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Area of Science:

  • Geriatric Psychiatry
  • Neurodegenerative Diseases

Background:

  • Severe aggression is a challenging behavioral and psychological symptom in dementia.
  • Current evidence-based guidelines for managing severe aggression in dementia are limited.
  • Antipsychotic medications, such as haloperidol, are often used despite potential risks.

Observation:

  • A case of a 60-year-old man with frontotemporal dementia and severe aggression managed with high-dose haloperidol.
  • Treatment decisions were based on literature review, expert consultation, and risk-benefit analysis.
  • The patient experienced rapid physical deterioration and subsequent death.

Findings:

  • Haloperidol use is associated with increased mortality in patients with dementia.
  • This case underscores the difficulties in managing severe aggression in dementia.
  • There is a lack of consensus and safe, effective treatment options for severe aggression in dementia.

Implications:

  • The findings highlight the urgent need for improved management strategies for severe aggression in dementia.
  • Further research is required to identify safer and more effective treatments.
  • Clinical practice must carefully weigh the risks and benefits of haloperidol in this vulnerable population.