Medicating Dementia

A number of medicines have been approved for the treatment of dementia.  Unfortunately, none of the medications currently available can reverse or halt the disease.  At best, they may slow it nominally.  Best results occur if the medication is started when a patient has Mild Cognitive Impairment and has not yet progressed further into dementia.  The medicines used currently include AChE inhibitors and NMDA Blockers.

Dementia can co-exist with other issues such as depression.  As a result, the dementia patient may also be taking SSRIs to treat their depression.  Of the available medical treatments, the SSRIs have the fewest side effects for dementia patients.  Unfortunately, recent findings published in the British Journal of Clinical Pharmacology indicate that dementia patients on SSRIs have an increased risk of falling in addition to an increased risk of being injured from the fall than dementia patients not on SSRIs.

Antipsychotics may be prescribed (PDF) if the dementia patient starts exhibiting aggression to the point of not being able to be calmed down.  However, antipsychotics have not been approved for use in treatment of dementia related aggression or anxiety.  This does not mean they don't help.  They very well may.

Currently, Lyn is not medicated for her dementia.  She does not want to take anything and the neurologist did not offer medication as an option.  The neurological exams ruled depression out as a cause for her symptoms.  Thus, there is no need for her to take an SSRI.  While she has days where she is hostile and rude, she has not threatened anyone, destroyed anything and can still be calmed down.  This rules out treatment for her behavior at this time.

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