[Pharmacological treatment of behavioral symptoms in dementia patients].

Cognitive manifestations usually are the primary abnormalities in dementia. In most cases cognitive deterioration arise in association with behavioral disturbances, and may accelerate institutionalization of patients. Noncognitive symptoms are distressing for both patients and their caregivers. These symptoms are described as "behavioral and psychological symptoms of dementia--BPSD" or neuropsychiatric symptoms. BPSD occurs in all types of dementia, and often are among the most prominent symptoms in the clinical course of the disease. Some disturbances like agitation and aggression may be disruptive and life-treating for patients and surrounding people. Non-pharmacological interventions should be recommended as a first line treatment unless BPSD symptoms are severe, persistent or recurrent. Drug treatment should have a specific target symptom. Atypical antipsychotics are widely used as the first line pharmacological approach to treat BPSD. Antidepressants, anxiolytics and antiepileptic's are also used. Treatment with cholinesterase inhibitors and/or memantine may delay the onset of BPSD and reduce the severity of some symptoms. Effective and safe treatment of BPSD should significantly improves the quality of life of patients and their caregivers.