Bromocriptine treatment for perseveration in demented patients

Some forms of behavioral perseveration may reflect the disruption of specif ic neurotransmitter systems including mesencephalic dopaminergic projection . We present an open-labeled trial of a dopamine agonist for treating perse veration in dementia. Eight patients with ischemic vascular or degenerative dementia completed a 25-day trial of bromocriptine with a maximum daily do se of 10 mg. Patients were assessed with neuropsychological scales and a te st battery for detecting perseveration. Recurrent and stuck-in-set types of perseveration significantly improved during the treatment, whereas measure s for general attention and overall cognitive function showed no significan t changes. We assume that bromocriptine supplemented the mesolimbocortical or ventral mesostriatal dopamine system ameliorated a certain frontal lobe function such as focused attention or working memory and improved the patie nts' perseverations. Although this study is preliminary because of the smal l sample size and open-labeled design, the results underline the possibilit y of pharmacotherapy for perseveration and recommend a double-blind, placeb o-controlled study.