BMJ 1999;319:138-139 ( 17 July )

Editorials

Treating behavioural and psychological signs in Alzheimer's disease

The evidence for current pharmacological treatments is not strong

The first 150 words of the full text of this article appear below.

Dementia is a prominent healthcare issue for primary care physicians and specialist services. Over 90% of patients with dementia experience a "behaviour disturbance,"¹ often referred to as behavioural or psychological signs in dementia in accordance with the recommendation of the International Psychogeriatric Association. These symptoms are distressing to patients and troublesome to carers and often precipitate admission to residential facilities.¹ What is the evidence that any of the several drugs that are currently used to treat these symptoms are effective?

Managing the behavioural and psychological signs of dementia is a major problem for healthcare professionals. Neuroleptic drugs are the mainstay of pharmacological treatment, although their use is justified largely on the basis of clinical anecdote, and they have many harmful side effects. These include parkinsonism, drowsiness, tardive dyskinesia, falls, accelerated cognitive decline,² and severe neuroleptic sensitivity reactions.³ It is therefore not surprising that the chief medical officer has recommended judicious . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Should acetylcholinesterase inhibitors be tried before neuroleptics?

Tomasz Sobow
bmj.com, 17 Jul 1999 [Full text]

Other important issues need to be addressed in further clinical trials

Ajit Shah
bmj.com, 19 Jul 1999 [Full text]

Strong agreement with the need for double blind trials.

Richard Gray
bmj.com, 16 Aug 1999 [Full text]

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