Atypical Antipsychotics for Behavioral and Psychological Symptoms in Alzheimer's Dementia

ABSTRACT

In addition to cognitive and functional decline, various behavioral and psychological symptoms in dementia (BPSD) are manifested in the patients with Alzheimer's dementia (AD). Some of BPSD, especially psychosis, agitation, and aggression could be challenges to caregivers and clinicians. Atypical antipsychotic drugs (risperidone, olanzapine, quetiapine, and aripiprazole) are widely prescribed to manage complicated neuropsychiatric symptoms associated with AD. It is known that atypical antipsychotics (AAP) have modest and significant beneficial effects in the short term treatment of BPSD. However their safety of AAP has been concerned with potentially increased adverse events. This article reviewed the treatment outcomes and adverse effects of AAP when managing BPSD in the patients with AD. The effects of risperidone and aripiprazole are obvious on psychosis and aggression, but with small effect size. AAP could exacerbate cognitive decline, and it could increase the rate of cerebrovascular accidents and mortality rate in the patients with AD.