When non-pharmacological approaches to managing behavioral disturbances in dementia are insufficient, acetylcholinesterase inhibitors, SSRIs, and second generation antipsychotic medications should be considered.
Donepezil and other acetylcholinesterase inhibitors are the first-line medications used for cognitive and neuropsychiatric symptoms of Alzheimer’s Dementia, including mild-to-moderate anxiety, depression, irritability, and agitation.
Strategies for tapering chronic benzodiazepines include: go slow, stop slow as you go low, consider switching to diazepam, provide additional psychological support, consider the context, and write it down.
How do you taper long-term benzodiazepines? Read More »
Benzodiazepines are associated with falls, fractures, impaired cognitive functioning, and dementia; the American Geriatric Society strongly recommends avoiding their use in the elderly.
How do you counsel an older patient about the risks of benzodiazepines? Read More »
General non-pharmacologic strategies to address behavioral and psychological symptoms in a person with dementia and specific strategies to reduce the potential harms of wandering are reviewed.
How do you manage behavioral and psychological symptoms in a patient with dementia? Read More »
SSRIs rarely cause hyponatremia, but the risk is higher in older adults and people taking thiazide diuretics. Check a Na in a patient who becomes confused or more lethargic soon after starting an SSRI.
