The Place for Electroconvulsive Therapy in the Management of Behavioral and Psychological Symptoms of Dementia

Tampi, Rajesh R.; Tampi, Deena J.; Young, Juan; Hoq, Rakin; Resnick, Kyle

doi:10.2217/nmt-2019-0018

Cited by 10 publications

(1 citation statement)

References 37 publications

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“…In their literature review, Tampi et al found a total of 20 published reports that evaluated the use of ECT for BPSD. 31 These reports included a total of 172 individuals with BPSD who were treated with ECT. Forty percent of the study were case reports, which was followed by retrospective chart reviews (25%) and case series (20%).…”

Section: Introductionmentioning

confidence: 99%

Prazosin for the management of behavioural and psychological symptoms of dementia

Tampi¹,

Tampi²,

Farheen³

et al. 2022

DIC

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Prazosin, a centrally acting α1 adrenoceptor antagonist, has been included in two published algorithms amongst the list of medications that may be used in the management of behavioural and psychological symptoms of dementia (BPSD). However, a review of PubMed, Ovid and Cochrane Collaboration found that there was only one small published randomized controlled trial (RCT) that evaluated the use of prazosin amongst individuals with BPSD. Evidence from this good quality RCT indicates that prazosin appears to benefit individuals with agitation and aggression amongst individuals with BPSD and this medication is well tolerated. When compared to other treatments for BPSD, including atypical antipsychotics, antidepressants, acetylcholinesterase inhibitors, memantine, repetitive transcranial magnetic stimulation and electroconvulsive therapy, where there are multiple studies for each of these treatment modalities, the data for the use of prazosin for BPSD are limited to just one good quality RCT. Given the limitations in available data, the routine use of prazosin for the treatment of BPSD cannot be recommended at this time. However, prazosin may be used for the management of agitation and aggression amongst individuals with dementia when other medication classes, like acetylcholinesterase inhibitors, memantine, antidepressants and/or atypical antipsychotics, have been ineffective or not tolerated.

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Section: Introductionmentioning

confidence: 99%

Prazosin for the management of behavioural and psychological symptoms of dementia

Tampi¹,

Tampi²,

Farheen³

et al. 2022

DIC

Self Cite

View full text Add to dashboard Cite

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Prescribing in Older People

2021

The Maudsley Prescribing Guidelines in Psychiatry

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The pharmacokinetics and pharmacodynamics of most drugs are altered to an important extent in older people. Older people often have a number of concurrent illnesses and may require treatment with several drugs. Older people may be more prone to develop serious adverse effects such as agranulocytosis and neutropenia with clozapine, stroke with antipsychotic drugs and bleeding with selective serotonin reuptake inhibitors. This chapter summarizes guidance for discontinuation of dementia medication in clinical practice. People with dementia are more susceptible to cognitive side effects of drugs. Medications prescribed for physical disorders may interact with cognitive‐enhancing medication. The evidence for efficacy of antidepressants in behavioural and psychological symptoms of dementia is mixed and limited showing that antidepressants are most helpful for treating agitation and less so for depression, apathy, anxiety or psychosis in dementia. The chapter deals with covert medication provision within UK law only. In mental health settings it is common for patients to refuse medication.

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