One of the greatest challenges, when it comes to Alzheimer’s disease and other dementias, is coping with difficult behaviors.These are symptoms beyond the chronic memory/thinking problems that are the hallmark of dementia.(See How You Can Help Someone Stop Ativan for more information.) : A recent review of clinical research concluded there is “limited evidence for clinical efficacy.” Although these drugs do have a noticeable effect when they are used, it’s not clear that they overall improve agitation and difficult behaviors in most people. These include medications otherwise used for seizures. However, they take weeks or even months to reach their full effect on depression or anxiety symptoms.It is also not clear that they work better than antipsychotics, for longer-term management of behavior problems. They generally reduce the “excitability” of brain cells. The effects of these medications on agitation is variable.Benzodiazepines vary in how long they last in the body: alprazolam is considered short-acting whereas diazepam is very long-acting.In older adults who take benzodiazepines regularly, there is also a risk of worsening dementia symptoms when the drug is reduced or tapered entirely off.The circumstances around the 18 deaths were not clear, Yin said.
(A possible exception: geriatricians do often consider medication to treat pain or constipation, as these are common triggers for difficult behavior.) Instead, medications should be used after non-drug management approaches have been tried, or at least in combination with non-drug approaches.
(Learn about these here: 7 Steps to Managing Difficult Dementia Behaviors Safely & Without Medications.) Of course in certain situations, medication should be considered.
If your family member has Alzheimer’s or another dementia, I want you to be equipped to work with the doctors on sensible, judicious use of medication to manage difficult behaviors.
Most medications used to treat difficult behaviors fall into one of the following categories: 1. These are medications originally developed to treat schizophrenia and other illnesses featuring psychosis symptoms.
(For more on psychosis, which is common in late-life, see 6 Causes of Paranoia in Aging & What to Do.) Most antipsychotics are sedating, and will calm agitation or aggression through these sedating effects.