AGGRESSIVE-BEHAVIOR IN DEMENTIA AND ITS PHARMACOLOGICAL TREATMENT - A REVIEW

Aggression and other behavioural disturbances are frequent in dementia. Aggressive behaviour is associated both with the severity of dementia and with the presence of psychiatric and depressive symptoms and causes great distress for the patients and the caregivers. Both pharmacologic and behavioural strategies are necessary in dealing with these problems. Before treatment, a thorough medical and psychiatric examination is necessary. Neuroleptics are the most frequently used drugs in the treatment of aggressive behaviour in dementia. Empirical research has demonstrated a significant, but moderate, effect for these drugs. However, side-effects are frequent and severe in this group of elderly people with organic brain disease. There are few studies with adequate methods examining alternative drug strategies. However, when aggressive behaviour is associated with depressive symptoms, seizure disorder, anxiety and insomnia, manic symptoms, and Parkinson's disease, alternative drugs like serotonin reuptake inhibitors, carbamazepine, benzodiazepines, lithium, and L-deprenyl should be considered.