Psychosis, behavioral disturbance, and the use of neuroleptics in dementia

Despite the widespread use of psychotropic agents in patients with dementia, there is little available research on the nature and prevalence of psychiatric disturbance and behavioral syndromes requiring this treatment, and the results of such therapy. The authors suggest strategies to overcome difficulties inherent in attempting to obtain symptom profiles in demented patients. There is weak evidence to support the use of neuroleptics in the treatment of symptoms like suspiciousness, hallucinations, sleeplessness, agitation, emotional liability, and aggressiveness; no individual neuroleptic can be considered superior to any other for this purpose. Few studies have evaluated the effect of neuroleptics on activities of daily life (ADL), and no study has used detailed neurophsychological evaluation to examine their effects on cognitive function in dementia.