PHARMACOLOGICAL TREATMENT OF NONCOGNITIVE SYMPTOMS OF DEMENTIA

Cognitive deterioration in dementia includes many changes besides memo ry disturbances, including agitation, delusions, hallucinations, anxie ty, irritability, and aggressiveness. Antipsychotic drugs are often us ed to control behavioral symptoms, but their benefits are limited. Dep ression, which is common in dementia, is often associated with anxiety . Selective serotonin reuptake inhibitors (SSRIs) improve mood and red uce anxiety while causing few side effects; they are also useful in ma naging irritability. Thus, the SSRIs should be considered the agents o f choice for treating noncognitive symptoms associated with dementia. Neuroleptics should be used exclusively in patients with severe behavi oral or psychotic symptoms, and only those agents without anticholiner gic effects should be administered. Neuroleptics can be coadministered with SSRIs in patients who are extremely aggressive. Anxiolytics may also be effective for shortterm use. Future studies of drugs to treat the noncognitive symptoms of dementia should be placebo controlled and should evaluate the effects of those drugs on cognitive function.