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Cause of behavioural and psychological symptoms of dementia needs to be established first

  1. Esme Moniz-Cook, senior clinical lecturer (E.D.Moniz-Cook@hull.ac.uk),
  2. Michael Bird, coordinator of aged mental health
  1. Division of Psychological and Primary Care Medicine, Postgraduate Medical Institute, University of Hull, Hull York Medical School, Hull HU6 7RX
  2. NSW Southern Area Health Service, PO Box 1845, Queanbeyan, NSW 2620, Australia
  3. Moseley Hall Hospital, Birmingham B13 8JL

    EDITOR—Burns et al urge caution in prescribing neuroleptic drugs for agitation in dementia and advance the cause of psychosocial alternatives, citing good evidence in support of bright light and aromatherapy.1

    A conceptual problem remains. It is analogous to reflex prescription of neuroleptics (although with less risk of side effects) to attempt standard psychosocial cures before assessing causes of the behaviour—well beyond essential screening for physiological aetiology such as infections or drug interactions. For example, sleep disturbance in nursing homes is commonly caused …

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