Psychiatr. praxi. 2024;25(3):115-119 | DOI: 10.36290/psy.2024.019

Pharmacotherapy of restlessness in dementia

doc. MUDr. Roman Jirák, CSc.
Psychiatrická klinika 1. LF UK a VFN Praha

Neuropsychiatrical symptoms of dementia are a serious group of disorders in dementia. Among them, the most noticeable and most disturbing are the symptoms of restlessness - agitation, gross restlessness, aggressiveness. These symptoms often lead to the patient being hospitalized or placed in a specialized social service facility. Mainly non-pharmacological approaches are used to alleviate restlessness, but they are often not enough. Therefore, it is necessary to use pharmacotherapy. The article discusses the possibilities of this type of treatment, its advantages and disadvantages.

Keywords: agitation, antipsychotic, dementia, pharmacotherapy, restlessness.

Accepted: October 2, 2024; Published: November 15, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Jirák R. Pharmacotherapy of restlessness in dementia. Psychiatr. praxi. 2024;25(3):115-119. doi: 10.36290/psy.2024.019.
Download citation
PDF will be unlocked 15.11.2025

References

  1. Álvarez-Fernández B, Brental-López MR, Gómez-Huelgas R. Role of aripiprazol in the management of behavioural and psychological symptoms of dementia:a narrative review. Psychogeriatrics. Nov. 2021;22(1). DOI 10.1111/psy.g.12787. Go to original source...
  2. Brimelow RE, Wollin JA, Byrne GJ, et al. Prescribing of psychotropic drugs and indicators for use in residential agend care and residents with dementia. Int Psychogeriatr. 2019;31:837-847. Go to original source... Go to PubMed...
  3. Chen K, Li H, Yang L, et al. Comparative efficacy and safety of antidepressant therapy for the agitation of dementia: A systematic review and network meta-analysis. Systematic Review article. Frongt. Aging Neurosci. 2023;15:https://doi.org/10.3389/fnagi.2023.1103039. Go to original source... Go to PubMed...
  4. Cole SA, Saleem R, Smith A. Ziprasidon for Agitation or Psychosis in Dementia. Int J Psychiatry Med. 2005;35(1):91-8. https://doi.org/10.2190/NAMG-XXGG-WDVY-GX04. Go to original source... Go to PubMed...
  5. Coles M. Caution with olanzapine use in dementia. Austr. Prescr. 2021;44(2):40. Go to original source... Go to PubMed...
  6. De Deyn PP, Rabheru K, Rasmussen A, et al. A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms of dementia. Neurology. 1999;53(5):956. Go to original source... Go to PubMed...
  7. Devshi R, Shaw S, Elliot-King J, et al. Prevalence of Behavioural and Psychological Symptom of Dementia in Individuals with Learning Disabilities. Diagnlostics. 2015;5:564-576. Go to original source... Go to PubMed...
  8. Fernandez HH, Trieschmann ME, Burke MA, et al. Quetiapine for psychosis in Parkinson's disease vwersus dementia with Lewy bodies. Journ of Clin Psychiat. 2002;63(6):513-515. Go to original source... Go to PubMed...
  9. Grossberg GT, Kohegyi E, Mergel V, et al. Efficacy and Safety of Brexpiprazole for the Treatment of Agitation in Alzheimer'sDementia: Two12-Week. Randomized, Double-Blind, Placebo-Controlled Trials. The Amer Journ of Geriat Psychiatry. 2020;28(4):383-400. Go to original source... Go to PubMed...
  10. Kikuchi Sugwara Y, Shimizu T. Aripiprazole for the treatment of psychotic symptoms in patiens with dementia with Lewy bodies: a case series. NeuropsychiatricDisease and Treatment. 2019;15:543-547. Go to original source... Go to PubMed...
  11. Lee D, Stomkowski M, Hefting N, et al. Brexpiprazole for the treatment of agitation in Alzheimer Dementia. A randomized clinical trial. JAMA Neurology. 2023;80(12):1307-1316. Go to original source... Go to PubMed...
  12. Lin Y-T, Hwang T-J, Shan J-Ch, et al. Dosage and durativ of antipsychotik treatment in demented outpatients with agitation or psychosis. Journ of Formosan Medic Assoc, 2015;4(2):147-153. Go to original source... Go to PubMed...
  13. Müller L, Noseda R, Bertoli R, et al. Off-label use of quetiapijne in nursing homes: Does medici speciality of prescribing physicans play a role? BJCP. 2020;86(7):1444-1445. Go to original source... Go to PubMed...
  14. Ohno Y, Kunisawa N, Shimizu S. Anrtipsychotic Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD) Management of Extrapyramidal SideEffects. Front. Pharmacol. 2019;10:1045. doi:10.3389/fphar.2019.01045. Go to original source... Go to PubMed...
  15. Prokopová I. Farmakoterapie Alzheimerovy demence a přidružených neuropsychiatrických symptomů - 2. část. Psychiatr. praxi 2018;19(2):58-63. Go to original source...
  16. Protopopová D, Masopust J, Vališ M, et al. Použití antipsychotik u nemocných s demencí. ČeskSlovNeurol a Neurochir. 2015;78/111(2):158-162.
  17. Rocha FL, Hara C, Ramos MG, et al. An Exploratory Open-Label Trial of Ziprasidone for the treatment of Behavioral and Psychological Symptom sof Dementia. Dement Geriatr Cogn Disord. 2006;22(5-6):445-448. Go to original source... Go to PubMed...
  18. Roughley M, Mena C, Howard R, et al. Guiding safe risperidone prescribing in Alzheimer's dinase with therapeutic drug monitoring. SHORT COMMUNICATION, Open Access, firstpubl: 15 Feb. 2023, https://doi.org/10.1111/bcp.15692. Go to original source... Go to PubMed...
  19. Tampi RR, Tampi DJ, Sirinivasan S, et al. Antipsychotic use in dementia: a systematic review of benefit and risk from meta-analyses. Therapeutic Advances in Chronic Diseases. Amer JournofGeriat Psychiatry. 2017;25(3):81. Go to original source...
  20. Tampi RR, Tampi DJ, Balachandran S. Antipsychotics, Antidepressants, Anticonvulsans, Melatonin, and Benzodiazepines for Behavioral and Psychological Symptoms of Dementia: a Systematic Review of Meta-analyses. J Geriatric Disorders. 2017;5:55-79. Go to original source...
  21. Tampi RR, Tampi DJ. Efficacy and tolerability of benzodiazepines for the treatment of behavioral and psychological symptoms of dementia: A systematic review of randomized controlled trials. Amer Journ of Alzhem Dis and Other Dementias. 2014;19(7):565-574. Go to original source... Go to PubMed...
  22. Tampi RR, Tampi DJ, Farheen SA, et al. Propranolol for the management of behavioural and psychological symptoms of dementia, Drug Context. 2022 Dec. 8:11:2022-8-3.doi. 10.7573/dic.2022-8-3. eCollection 2022. Go to original source... Go to PubMed...
  23. Yeh Y-CH, Ouang W-CH. Mood stabilizers for the treatment of behavioral and psychological symptpoms of dementia. SciVerse ScienceDirect, Available online 14. Feb. 2012.
  24. Young JJ. Evidence-Based Pharmacologial Management and Treatment of Behavioral and Psychomogical Symptom sof Dementia. The Amer. JNourn. Of Psychiat. 2016;14(6):3-5. Go to original source...
  25. Yunusa I, El Helou ML. The Use of Riseridone in Behavioral and Psychological Symptoms of Dementia: A Review of Pharmacology, Clinical Evidence, Regulatory Approvals, and Off-Label Use. Front Pharmacol. 2020;11:596. Go to original source... Go to PubMed...




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.