TREMENDOUS ADVANCES HAVE TAKEN place over the last five years in the drug treatments of dementia. Yet what has been achieved is merely the tip of the iceberg; much more research will be needed before a cure can be proclaimed for any of the dementing disorders. Current treatments are aimed at ameliorating the symptoms of dementia rather than targeting the underlying causes. Except for a few treatments for specific disorders, current available drug treatments are used across most types of dementia. Here I consider the main domains of treatment and discuss the different options in each domain. As it is not my intent to provide a ‘how to’ guide for the management of dementia, I give a broad overview of the different drug types rather than providing a great deal of detail on how to use specific drugs. However, I go into some detail on the cholinesterase-inhibitor drugs, due to the stringent Australian Pharmaceutical Benefits Scheme (PBS) regulations.
All drugs have side-effects of some sort; in people with dementia increased confusion is common. As the number of drugs prescribed increases, the risk of confusion increases. Drugs that are used in the treatment of dementia may take many weeks to show a positive effect, so providing there are no obvious side-effects, it is important to give each treatment an adequate trial. However, where a drug causes significant side-effects before a positive effect can be determined, it is probably best to discontinue it. In making such a decision the potential, and often intangible, long-term benefits need to be considered, and the decision is not always easy.