Pharmacologic therapies in dementia

To review past and current pharmacologic therapies for cognitive and behavioral problems in elderly patients with dementia.

We surveyed the pertinent medical literature and present detailed findings on results of pharmacotherapeutic interventions for cognitive loss and behavioral disorders.

Numerous drugs have been used in an attempt to reverse or forestall the cognitive decline associated with dementia. Currently available agents are limited by either lack of efficacy or occurrence of adverse effects. Medications are also used to control undesirable behaviors associated with dementia. Depending on the individual circumstance, such pharmacologic therapies may be of limited utility, some may be harmful, and others may be effective. The use of psychotropic agents in nursing homes is strictly regulated by federal law. For appropriate care of elderly patients with dementia, knowledge of the available drug therapies and their effectiveness is necessary.

Drug therapies for dementia are associated with adverse effects in the elderly population. Drugs for management of aggressive behaviors associated with dementia should be used only when nondrug strategies have failed. In each patient with dementia, underlying cognitive and behavioral problems must be thoroughly evaluated for selection of the most appropriate drug.