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Pharmacotherapy of Dementia

  • Living reference work entry
  • First Online:
Mental Health and Illness of the Elderly

Part of the book series: Mental Health and Illness Worldwide ((MHIW))

Abstract

Alzheimer’s disease (AD), the most common form of dementia, is a progressive and debilitating condition that causes deterioration in cognition and function, as well as disturbances in behavior. Currently available treatments for AD (donepezil, rivastigmine, galantamine, and memantine) are symptomatic and do not prevent the progression of the disease. These therapies demonstrate modest but consistent benefit for cognition, global status, functional ability, and behavioral disturbances or neuropsychiatric symptoms. The search for disease-modifying interventions has focused largely on compounds targeting the amyloid-β pathway. Current efforts are also geared toward other disease hallmarks such as tau pathology, neuroinflammation, and mitochondrial dysfunction. Given the negative results of disease-modifying drug candidates for mild-to-moderate AD patients, a large number of trials are focusing on the early or prodromal stages of the disease. Neuropsychiatric symptoms, including apathy, depression, agitation and aggression, sleeping disorders and insomnia, and psychotic symptoms, are prevalent in dementia and have a negative impact on both quality of life and caregiver burden. Pharmacological management of specific neuropsychiatric symptoms is also a focus of clinical trials. Given that AD patients are frailer and have more comorbid illnesses, the prescription of psychotropic medications, particularly those of questionable benefit, should be done with careful consideration. In this chapter, we critically examine evidence of the safety and efficacy of currently approved drugs and emerging pharmacotherapies in AD.

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Authors and Affiliations

  1. Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada

    Sarah A. Chau, Celina S. Liu, Myuri Ruthirakuhan & Krista L. Lanctôt

  2. Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, ON, Canada

    Sarah A. Chau, Celina S. Liu, Myuri Ruthirakuhan, Krista L. Lanctôt & Nathan Herrmann

  3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Krista L. Lanctôt & Nathan Herrmann

  4. Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Room FG08, M4N 3M5, Toronto, ON, Canada

    Nathan Herrmann

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  1. Sarah A. Chau
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  4. Krista L. Lanctôt
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  5. Nathan Herrmann
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Correspondence to Nathan Herrmann .

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  1. The Chinese University of Hong Kong, Tai Po, Hong Kong

    Helen Chiu

  2. Sunnybrook Research Institute, Toronto, Ontario, Canada

    Kenneth Shulman

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© 2016 Springer Nature Singapore Pte Ltd.

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Chau, S.A., Liu, C.S., Ruthirakuhan, M., Lanctôt, K.L., Herrmann, N. (2016). Pharmacotherapy of Dementia. In: Chiu, H., Shulman, K. (eds) Mental Health and Illness of the Elderly. Mental Health and Illness Worldwide. Springer, Singapore. https://doi.org/10.1007/978-981-10-0370-7_20-1

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  • DOI: https://doi.org/10.1007/978-981-10-0370-7_20-1

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  • Print ISBN: 978-981-10-0370-7

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