Navigating the Challenges of Dementia: Understanding & Managing Behavioral & Psychological Symptoms-View Presentation

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Video Summary

The presentation focused on behavioral and psychological symptoms of dementia (BPSD), specifically in Alzheimer's disease. Dr. Rajesh Tempe discussed various treatment approaches, including both non-pharmacological and pharmacological strategies. The only FDA-approved medication for agitation in Alzheimer's is brexpiprazole (Rexulti), with other treatments being off-label.<br /><br />Non-pharmacological interventions are emphasized as the cornerstone for managing BPSD, with consistent support for psychoeducation, cognitive stimulation, and therapeutic activities. Pharmacologically, antidepressants such as sertraline and citalopram are preferred for initial treatment. Atypical antipsychotics like aripiprazole and risperidone may be used when necessary, but there is a risk of cognitive decline and mortality associated with these. Brexpiprazole has shown promise for managing agitation.<br /><br />Mood stabilizers and benzodiazepines are less effective and are typically not recommended. Other potential treatments include cannabinoids, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT), especially for treatment-resistant cases.<br /><br />Dr. Tempe emphasized the importance of individualized treatment plans, close monitoring of side effects, and considering non-emergent agitation approaches first. He highlighted the significant caregiver burden and the need for thorough cognitive and medical assessments.<br /><br />Lastly, he pointed out controversies, such as the risk of mortality and cerebrovascular adverse effects associated with antipsychotic use in dementia patients, urging careful prescribing practices. The session ended with a Q&A addressing practical concerns and treatment nuances in dementia care.

Keywords

BPSD

Alzheimer's

brexpiprazole

non-pharmacological

pharmacological

antidepressants

atypical antipsychotics

cognitive stimulation

treatment approaches

caregiver burden

side effects