Behavioral problems such as agitation, hallucinations, paranoia and wandering are very common with Alzheimer's disease (AD) and other dementias, as is depression. These symptoms are distressing to both the individual and the caregivers, and often initiate the decision to look for placement in some type of care environment.
There are medications to help manage some of these behaviors, but unfortunately many have serious side effects. Therefore it is important to first rule out or treat any underlying medical cause, since it is not uncommon for someone with a urinary tract infection, pneumonia, or medical toxicity to exhibit confusion and other behavioral symptoms.
Common medication treatments include:
Antipsychotic or psychotropic drugs (such as Haldol and Thorazine) are widely used to treat hallucinations in people with dementia. However, studies have not shown that they help with other behaviors, and they can even worsen memory and cognition.
Atypical Antipsychotics (such as Zyprexa and Risperdal) have a lower incidence of side effects and can be moderately effective. But the FDA has advised that the use of these drugs for elderly with dementia is associated with increased mortality.
Antidepressants (such as Celexa and Zoloft) can be helpful in controlling behavioral symptoms that are related to a serotonin deficiency.
Antiseizure drugs have been studied for the treatment of behavioral problems in individuals with dementia, but have shown little benefit.
Antianxiety medications such as Lorazepam can provide short term benefits, so are primarily recommended for acute stressful events.
Behavioral symptoms can also be treated without the use of drugs:
Behavioral Therapy employs different strategies such as redirection, activity engagement, or communication skills.
Aromatherapy and Music, Touch and Pet Therapies have all been shown to decrease agitation through sensory stimulation.
Physical Exercise can decrease depression and has many other benefits as well.
A combination of environmental modifications, meaningful activity, and medication is usually the best approach.
