Antidepressants. Antidepressants such as sertraline, citalopram, mirtazapine and trazodone are widely prescribed for people with dementia who develop changes in mood and behaviour. There is some evidence that they may help to reduce agitation – particularly citalopram.
Doctors may prescribe the following brand name drugs: Antidepressants: Celexa, Desyrel, Paxil, Prozac, and Zoloft. Anxiolytics: Ativan and Serax.
Today, the U.S. Food and Drug Administration is announcing the supplemental approval of Rexulti (brexpiprazole) oral tablets for the treatment of agitation associated with dementia due to Alzheimer's disease. This is the first FDA-approved treatment option for this indication.
In the early stages of Alzheimer's disease patients may experience behavior and personality changes such as increased irritability, anxiety and depression. Often times these changes are the motive why families decide to seek out medical help.
Changes in mood
Depression is a particularly common vascular dementia symptom. A person may become depressed because they are worried about having dementia. Depression can also be caused by damage to parts of the brain that control emotions.
It is recommended that people with Alzheimer's should NOT take anticholinergic drugs. These drugs are used to treat many medical problems such as sleeping problems, stomach cramps, incontinence, asthma, motion sickness, and muscle spasms. Side effects, such as confusion, can be serious for a person with Alzheimer's.
The bottom line
To decrease agitation and aggression in people with dementia, nondrug options are more effective than medications. Physical activity, touch and massage, and music can all be used as tools to manage agitation related to dementia.
Melatonin. Melatonin supplements are used to improve sleep, and may, theoretically, prevent the progression of dementia. Omega-3 fatty acid. Found in fish oil supplements, this fatty acid is thought to have many potential benefits for the brain.
The following are used to temporarily improve dementia symptoms. Cholinesterase inhibitors. These medications — including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) — work by boosting levels of a chemical messenger involved in memory and judgment.
Administration: The examiner reads a list of 5 words at a rate of one per second, giving the following instructions: “This is a memory test. I am going to read a list of words that you will have to remember now and later on. Listen carefully. When I am through, tell me as many words as you can remember.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
Cholinisterase Inhibitors are the most commonly prescribed medications for dementia. There are 3 cholinisterase inhibitors, which include, Donepezil, Galantamine and Rivastigmine.
Some of the more common triggers for dementia like a change in environment, having personal space invaded, or being emotionally overwhelmed may be easier to handle if you mentally practice your response before you react.
People with dementia can still have nice feelings too. They can feel happy, safe and calm. Some people with dementia may seem like their usual self a lot of the time and you may only notice small changes every now and then. Some people with dementia may not have as many good days.
This is known as sundowning and these behaviour changes can become worse after a move or a change in routine. The person with dementia may become more demanding, restless, upset, suspicious, disoriented and even see, hear or believe things that aren't real, especially at night.
Behavioral symptoms like moodiness, apathy, changes in personality, unsocial behaviors and language difficulty can be part of the disease. Behavior and personality often change with dementia.
In the earlier stages, memory loss and confusion may be mild. The person with dementia may be aware of — and frustrated by — the changes taking place, such as difficulty recalling recent events, making decisions or processing what was said by others.