Journal of Geriatric Mental Health

REVIEW ARTICLE
Year
: 2016  |  Volume : 3  |  Issue : 1  |  Page : 66--79

Pharmacotherapy of dementia


Ajit Avasthi, Gourav Gupta, Sandeep Grover 
 Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Sandeep Grover
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh
India

This review aims to evaluate the existing evidence for pharmacotherapy for management of dementia. Data search strategies included electronic databases of relevant publications or cross-references. The searches were limited to acetyl cholinesterase inhibitors (AChEIs), memantine, antipsychotics, antidepressants, mood stabilizers, and benzodiazepines. Data in the form of meta-analysis and systemic reviews for treatment in five main types of dementia (Alzheimer俟Q製, frontotemporal, Parkinson俟Q製, Lewy body disease, and vascular type) were extracted. If a meta-analysis or systemic review was not available, then the searches included evaluation of data in the form of double-blind, randomized controlled trials or open-label studies. Various studies suggest that compared to placebo, AChEIs and memantine are associated with better outcome in all domains of Alzheimer俟Q製 disease. In addition, combination therapy of AChEIs and memantine is superior to monotherapy with AChEIs in terms of behavioral disturbances, activities of daily living, and global assessment. In patients with dementia associated with Parkinson俟Q製 disease or Lewy body dementia, use of donepezil, rivastigmine, and memantine is associated with significant efficacy on the global outcome measures when compared with placebo. Compared to placebo, AChEIs, but not memantine, have also been shown to have better cognitive outcomes in patients with dementia associated with Parkinson俟Q製 disease or Lewy body dementia. Data are limited for the role of pharmacotherapy in management of frontotemporal dementia. In patients of vascular dementia, all AChEIs and memantine show some beneficial effects on cognition. Antidepressants and antipsychotics have been shown to be beneficial in management of behavioral symptoms and agitation. However, it is important to remember that there is black box warning for use of antipsychotics among patients with dementia. One of the major limitations of the research is variability in assessment instruments used for rating various symptoms encountered in patients of dementia. However, it can be concluded that in recent times, quality of studies has improved and many studies have included adequate sample sizes.


How to cite this article:
Avasthi A, Gupta G, Grover S. Pharmacotherapy of dementia.J Geriatr Ment Health 2016;3:66-79


How to cite this URL:
Avasthi A, Gupta G, Grover S. Pharmacotherapy of dementia. J Geriatr Ment Health [serial online] 2016 [cited 2022 Jan 27 ];3:66-79
Available from: https://www.jgmh.org/article.asp?issn=2348-9995;year=2016;volume=3;issue=1;spage=66;epage=79;aulast=Avasthi;type=0