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Alzheimer's Medications
What types of behavioral problems might be expected?
In later stages of the disease, people with Alzheimer's might experience distinct
changes in behavior or personality. In fact, the first recognized case of Alzheimer's,
back in 1906, was in a patient who had suffered paranoid delusions . Potential
behavioral symptoms, which are often lumped together as "agitation,"
may take many forms, such as aggressive behavior, wandering or pacing, rummaging
as if in search of something, paranoia, suspiciousness, combativeness or resistance
to maintaining personal hygiene. These symptoms can significantly decrease the
quality of life of all involved - patients and families - and can seem overwhelming
to families and caregivers. The inability to manage these types of symptoms is
the primary reason that many people with Alzheimer's must eventually be placed
in a long-term-care facility.
Are there ways to treat behavioral problems other than drugs?
Yes. It's important to understand that many problematic behaviors
may be reactions to co-existing medical or psychiatric conditions,
or to inappropriate methods of communication or interaction with
the person. Identifying and treating co-occurring
health problems is therefore critical as a first step in managing
behavioral problems. In addition, family and caregivers should learn
about proven techniques for communicating
with the afflicted person, modifying
the home environment and involving the person in therapeutic
activities, all of which can minimize problems. These strategies
are reviewed elsewhere in this section.
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What drugs are used to treat behavioral symptoms?
If non-drug approaches fail to adequately manage behavioral problems, talk
to your physician about medications that may help. You'll need to describe any
behavioral problems to your doctor, so you might want to use a journal to keep
track of day-to-day changes in behavior and note when symptoms arise, what might
precipitate them and what if anything helps resolve them when they do arise.
Your doctor may recommend appropriate medications, depending on
what the symptoms are, from a group of drugs generally referred
to as anti-agitation drugs. The types of medications that
might be used include antidepressants (if the patient has
depression); anti-anxiety drugs (also called anxiolytics),
anti-psychotic medications (some of which are also called
neuroleptics); sedatives, and sleep medications.
There are many different drugs within each of these classes of medication.
Each acts in a somewhat different way and has different side effects, some
of which may be severe. As a rule, doctors generally prescribe the lowest dose
possible to alleviate symptoms and adjust the dosage as necessary.
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