A nondrug approach to dementia
Nearly 9 out of 10 patients with dementia also suffer from behavioral symptoms. Several nonpharmaceutical interventions hold promise.
But clinicians need to use psychotropic medications with informed patient and/or caregiver consent.7 On a case-by-case basis, a trial of antipsychotics is often justified, despite the black box warning. A family may choose to try an antipsychotic despite the risk to help manage the patient at home in the hope of delaying or preventing institutionalization.
However, even with good home support, in conjunction with nonpharmacologic and/or pharmacologic therapies, most patients with dementia will eventually require institutionalization.47 Because patients and families often rely on family physicians to guide them through these difficult challenges and decisions, you’ll need to remain well versed on the available On a case-by- case basis, a trial of antipsychotics is often justified, despite the black box warning. treatments for the psychological and behavioral symptoms of dementia, as well as the resources available in your community.
CORRESPONDENCE
Jaqueline Raetz, MD, 331 NE Thornton Place, Seattle, WA 98125; jraetz@u.washington.edu
