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Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics

Dementia affects about 47 million people worldwide, number expected to exponentially increase within 30 years. Alzheimer’s disease (AD) is the most common dementia type, accounting on its own for almost 70% of all dementia cases. Behavioral and psychological symptoms (BPSD) frequently occur during t...

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Autores principales: Calsolaro, Valeria, Femminella, Grazia Daniela, Rogani, Sara, Esposito, Salvatore, Franchi, Riccardo, Okoye, Chukwuma, Rengo, Giuseppe, Monzani, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002184/
https://www.ncbi.nlm.nih.gov/pubmed/33803277
http://dx.doi.org/10.3390/ph14030246
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author Calsolaro, Valeria
Femminella, Grazia Daniela
Rogani, Sara
Esposito, Salvatore
Franchi, Riccardo
Okoye, Chukwuma
Rengo, Giuseppe
Monzani, Fabio
author_facet Calsolaro, Valeria
Femminella, Grazia Daniela
Rogani, Sara
Esposito, Salvatore
Franchi, Riccardo
Okoye, Chukwuma
Rengo, Giuseppe
Monzani, Fabio
author_sort Calsolaro, Valeria
collection PubMed
description Dementia affects about 47 million people worldwide, number expected to exponentially increase within 30 years. Alzheimer’s disease (AD) is the most common dementia type, accounting on its own for almost 70% of all dementia cases. Behavioral and psychological symptoms (BPSD) frequently occur during the disease progression; to treat agitation, aggressiveness, delusions and hallucinations, the use of antipsychotic drugs should be limited, due to their safety issues. In this literature review regarding the use of antipsychotics for treating BPSD in dementia, the advantages and limitation of antipsychotic drugs have been evaluated. The available medications for the management of behavioral and psychological symptoms are the antipsychotics, classed into typical and atypical, depending on their action on dopamine and serotonin receptors. First generation, or typical, antipsychotics exhibit lack of tolerability and display a broad range of side effects such as sedation, anticholinergic effects and extrapyramidal symptoms. Atypical, or second generation, antipsychotics bind more selectively to dopamine receptors and simultaneously block serotonin receptors, resulting in higher tolerability. High attention should be paid to the management of therapy interruption or switch between antipsychotics, to limit the possible rebound effect. Several switching strategies may be adopted, and clinicians should “tailor” therapies, accounting for patients’ symptoms, comorbidities, polytherapies and frailty.
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spelling pubmed-80021842021-03-28 Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics Calsolaro, Valeria Femminella, Grazia Daniela Rogani, Sara Esposito, Salvatore Franchi, Riccardo Okoye, Chukwuma Rengo, Giuseppe Monzani, Fabio Pharmaceuticals (Basel) Review Dementia affects about 47 million people worldwide, number expected to exponentially increase within 30 years. Alzheimer’s disease (AD) is the most common dementia type, accounting on its own for almost 70% of all dementia cases. Behavioral and psychological symptoms (BPSD) frequently occur during the disease progression; to treat agitation, aggressiveness, delusions and hallucinations, the use of antipsychotic drugs should be limited, due to their safety issues. In this literature review regarding the use of antipsychotics for treating BPSD in dementia, the advantages and limitation of antipsychotic drugs have been evaluated. The available medications for the management of behavioral and psychological symptoms are the antipsychotics, classed into typical and atypical, depending on their action on dopamine and serotonin receptors. First generation, or typical, antipsychotics exhibit lack of tolerability and display a broad range of side effects such as sedation, anticholinergic effects and extrapyramidal symptoms. Atypical, or second generation, antipsychotics bind more selectively to dopamine receptors and simultaneously block serotonin receptors, resulting in higher tolerability. High attention should be paid to the management of therapy interruption or switch between antipsychotics, to limit the possible rebound effect. Several switching strategies may be adopted, and clinicians should “tailor” therapies, accounting for patients’ symptoms, comorbidities, polytherapies and frailty. MDPI 2021-03-09 /pmc/articles/PMC8002184/ /pubmed/33803277 http://dx.doi.org/10.3390/ph14030246 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Review
Calsolaro, Valeria
Femminella, Grazia Daniela
Rogani, Sara
Esposito, Salvatore
Franchi, Riccardo
Okoye, Chukwuma
Rengo, Giuseppe
Monzani, Fabio
Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics
title Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics
title_full Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics
title_fullStr Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics
title_full_unstemmed Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics
title_short Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics
title_sort behavioral and psychological symptoms in dementia (bpsd) and the use of antipsychotics
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002184/
https://www.ncbi.nlm.nih.gov/pubmed/33803277
http://dx.doi.org/10.3390/ph14030246
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