World Federation of Societies of Biological Psychiatry guidelines for the pharmacological treatment of dementias in primary care

Abstract

Objective. To define a practice guideline for biological treatment of dementias for general practitioners in primary care. Methods. TThis paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the Biological treatment of Alzheimer's disease and other dementias for treatment in primary care (Ihl et al. 2011). The recommendations were developed by a task force of international experts in the field and are based on randomized controlled studies. Results. Anti-dementia medications neither cure, nor arrest, or alter the course of the disease. The type of dementia, the individual symptom constellation and the tolerability and evidence for efficacy should determine what medications should be used. In treating neuropsychiatric symptoms, psychosocial intervention should be the treatment of first choice. For neuropsychiatric symptoms, medications should only be considered when psychosocial interventions are not adequate and after cautious risk-benefit analysis. Conclusions. Depending on the diagnostic entity and clinical presentation different anti-dementia drugs can be recommended. These guidelines provide a practical approach for general practitioners managing dementias.

Key words::

• Dementia
• guidelines
• Alzheimer's disease
• Lewy body disease
• anti-dementia drugs
• neuropsychiatric symptoms

Acknowledgements

None.

Statement of interest

The development of these guidelines was not supported by any pharmaceutical company.

Ralf Ihl received grants/research support or was involved as consultant, speaker or in advisory boards or received author honoraria within the last three years from APK, Austroplant, BDI, Beltz Test, BOD, Caritas Siegen, Double Helix Development, Eisai, Friedrichverlag, GE Healthcare, Hogrefe, IFE, Janssen, KDA, Landesinitiative Demenz Service NRW, LVR Dueren, Lundbeck, Medical Tribune, Med. Komm., Novartis, Pfizer, Pfrimmer Nutritia, Pierrel, Schwabe, Thieme, Urban & Vogel, and Westermayer.

Robertas Bunevicius has received grants/research support, consulting fees, and honoraria within the last 3 years from Lundbeck, AstraZeneca, Teva, and GlaxoSmithKline.

Alistar Burns has no conflict of interest to declare.

Bruno Dubois has received grants/research support, consulting fees, and honoraria within the last 3 years from Eli Lilly, Pfizer, and Roche.

Lutz Frölich received honoraria from Novartis, Lundbeck and Boehringer Ingelheim and has served as consultant, speaker or on advisory boards for AstraZeneca, Axon Neuroscience, Nutricia, Eisai, Eli Lilly GE Health Care, Genentech/Roche, Kyowa, Merz Pharma, Novartis, Pfizer, Schering-Plough, Merck-Sharp & Dohme.

Siegfried Kasper received grants/research support, consulting fees, and honoraria within the last 3 years from AstraZeneca, Bristol-Myers Squibb, CSC, Eli Lilly, GlaxoSmithKline, Janssen Pharmaceutica, Lundbeck, MSD, Novartis, Organon, Pierre Fabre, Pfizer, Schwabe, Sepracor, Servier, and Wyeth.

Hans-Jürgen Möller has received grant/research support, consulting fees, and honoraria within the last years from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, MSD, Novartis, Organon, Otsuka, Pfizer, Schwabe, Sepracor, Servier, and Wyeth.

Lon Schneider has received grants from the NIH P50 AG05142, R01 AG033288, and R01 AG037561, the State of California, the Alzheimer's Association for a registry for dementia and cognitive impairment trials and grant or research support from Baxter, Genentech, Johnson & Johnson, Eli Lilly, Novartis, and Pfizer. He discloses that within the last 3 years, he has served as a consultant for and received consulting fees from Abbvie Laboratories, AC Immune, Allon, AstraZeneca, Baxter, Biogen Idec, Biotie, Bristol- Myers Squibb, Elan, Eli Lilly, EnVivo, GlaxoSmithKline, Johnson & Johnson, Lundbeck, Merck, Novartis, Piramal, Pfizer, Roche, Sanofi, Servier, Takeda, Tau Rx, Toyama, and Zinfandel; and in the past from Ipsen and Schwabe.

Florence Thibaut has no conflict of interest to declare.

Bengt Winblad has received research support from Dainippon Sumitomo Pharma Co Ltd and has served as a consultant at Advisory Board meetings for AC Immune, Axon, Diagenic, Eli-Lilly, Johnson&Johnson, Lundbeck, Merz, Novartis, Pfizer, Roche, and Servier.