August 27, 2010
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 with 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.
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 or list 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.