Evidence-based pharmacological treatment of dementia

The current literature on the pharmacological treatment of dementia was rev iewed and the strength of evidence for the efficacy of each drug was catego rized using an evidence-based approach. Acetylcholinesterase-inhibitors rep resent the only category of drugs with consistently demonstrable efficacy i n well-designed studies of Alzheimer's disease, although the effect is not large. There is a lack of prospective, controlled, randomized studies for m ost of the nootropics. Epidemiological evidence suggests prophylactic effec ts of oestrogens and anti-inflammatory agents, and a single large-scale tri al suggests that long-term administration of vitamin E or selegiline may be associated with improved outcome in patients with Alzheimer's disease. A n umber of drugs were reported to be effective in the treatment of non-cognit ive symptoms of dementia including classical and atypical neuroleptics, ant idepressants and anticonvulsants. The evidence for efficacy, however, is no t strong for the majority of these compounds.