The modern role of antipsychotics for the treatment of agitation and psychosis in Alzheimer’s disease

ABSTRACT

Introduction: Antipsychotics have long been the mainstay of treatment for agitation and psychosis in Alzheimer’s disease. Despite their current use successive studies have shown that they only confer a modest benefit which must be balanced against their well-established serious side effects (extrapyramidal symptoms, stroke, accelerated cognitive decline and mortality).

Areas covered: This review outlines the current guidance on antipsychotic usage and the evidence of their continued usage against a backdrop of emerging pharmacological treatments and an increasing emphasis on the importance of non-pharmacological interventions.

Expert commentary: The current justification for antipsychotic use in the context of the changing landscape of prescribing and provide a view on the most promising alternative candidates to this class of drug are appraised.

KEYWORDS:

• Agitation
• Alzheimer’s disease
• atypical antipsychotics
• dementia
• psychosis

Declaration of interest

C Ballard has received grants and personal fees from Lundbeck and Acadia, and personal fees from Roche, Orion, GlaxoSmithKline, Otusaka, Heptares, and Lily. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.