Abstract：
:Geriatric patients with dementia frequently present with agitation, aggression, psychosis, and other behavioral and psychological symptoms of dementia (BPSD). We present an update of our previously published algorithms for the use of psychopharmacologic agents in these patients taking into account more recent studies and findings in meta-analyses, reviews, and other published algorithms. We propose three algorithms: BPSD in an emergent, urgent, and non-urgent setting. In the emergent setting when intramuscular (IM) administration is necessary, the first-line recommendation is for olanzapine (since IM aripiprazole, previously favored, is no longer available) and haloperidol injection is the second choice, followed by possible consideration of an IM benzodiazepine. In the urgent setting, the first line would be oral second-generation antipsychotics (SGAs) aripiprazole and risperidone. Perhaps next could be then prazosin, and lastly electroconvulsive therapy is a consideration. There are risks associated with these agents, and adverse effects can be severe. Dosing strategies, discontinuation considerations, and side effects are discussed. In the non-emergent setting, medications are proposed for use in the following order: trazodone, donepezil and memantine, antidepressants such as escitalopram and sertraline, SGAs, prazosin, and carbamazepine. Other options with less support but potential future promise are discussed.
journal_name
Psychiatry Resjournal_title
Psychiatry researchauthors
Chen A,Copeli F,Metzger E,Cloutier A,Osser DNdoi
10.1016/j.psychres.2020.113641subject
Has Abstractpub_date
2021-01-01 00:00:00pages
113641eissn
0165-1781issn
1872-7123pii
S0165-1781(20)33302-3journal_volume
295pub_type
杂志文章,评审abstract：:Considerable evidence suggests that there is a relationship between pathologic aggressive behavior and low cerebrospinal fluid (CSF) concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in both humans and non-human primates. The purpose of this investigation is to examine the relationship bet...
journal_title：Psychiatry research
pub_type： 杂志文章
doi：10.1016/s0165-1781(99)00022-0
更新日期：1999-04-19 00:00:00
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journal_title：Psychiatry research
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pub_type： 杂志文章
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pub_type： 杂志文章
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pub_type： 杂志文章
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journal_title：Psychiatry research
pub_type： 临床试验,杂志文章
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journal_title：Psychiatry research
pub_type： 杂志文章
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journal_title：Psychiatry research
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.psychres.2016.11.020
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pub_type： 杂志文章
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journal_title：Psychiatry research
pub_type： 临床试验,杂志文章
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pub_type： 杂志文章,meta分析
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pub_type： 杂志文章
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pub_type： 杂志文章
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