Clinical and economic factors in the treatment of behavioural and psychological symptoms of dementia

The prevalence of behavioural and psychological symptoms of dementia (BPSD) exceeds 50% They cause distress to patients and caregivers, increase . res ource utilisation of various kinds, and form a high risk for accelerated ps ychiatric care through institutionalisation. Although evidence fur current pharmacological treatment is not strong and t he construct of BPSD is still not very clear, future aspects of treatment o f BPSD may be positive. If we look at overall success rates of the antipsyc hotics, the traditional antipsychotics have the highest combined success ra te of 63.1%, whereas the novel antipsychotics have an overall success rate of 56.1%. Haloperidol is the drug with the highest success rate of 65.4%, a lthough this drug is associated with parkinsonian adverse drug reactions. N ewer antipsychotics show promise in treating BPSD, but more convincing evid ence (e.g. from randomised clinical trials) is required. We provide an overview of the clinical, epidemiological and economic aspect s of BPSD and a review of the available literature on their pharmacological treatment. Although only 1 pharmacoeconomic study has been conducted on BP SD, it seems likely that these manifestations drastically increase the: bur den of dementia.