Pharmaceutical Therapies

Nerve growth factor, antioxidant therapy, and other drugs are being investigated
for the management of dementia. Psychotrophic medications such as
carbamazepine, desipramine, haloperidol, lorazepam, and thioridazine are
used to control symptoms of agitation, anxiety, confusion, delusions, depression,
and hallucinations in patients with dementia. Unfortunately, some
of the medications used to improve patients’ quality of life may not work,
may worsen memory deficits, or cause neurological effects such as irreversible
tremors (tardive diskinesia).

It is important to reduce cerebrovascular risk factors such as hypertension,
diabetes, smoking, hyperlipidemia, and coronary artery disease in patients
with vascular dementia. Dementia resulting from neurologic conditions
(Parkinson’s disease, normal-pressure hydrocephalus, brain lesions,
carotid artery disease) requires a neurological workup. Dementia related to
a hereditary condition requires referral for genetic counseling.

Sources for Further Study

Epstein, David, and James Gonnor. “Dementia in Elderly: An Overview.”
Generations 23, no. 3 (1999): 9-17. Presents an overview of various types of
dementia and their treatments.

Rabins, Peter V., Constantine G. Lyketsos, and Cynthia Steele. Practical Dementia
Care. New York: Oxford University Press, 1999. Written primarily
for medical professionals. Covers definitions, evaluation, diseases causing
dementia, care for the patient and the family, treatment options, terminal
care, and ethical and legal issues.
Schindler, Rachel. “Late-Life Dementia.” Geriatrics 55, no. 10 (2000): 55-57.
Discusses American Psychiatric Association guidelines for detecting and
treating dementia.

Teitel, Rosette, and Marc Gordon. The Handholder’s Handbook: A Guide to
Caregivers of People with Alzheimer’s or Other Dementias. New Brunswick, N.J.:
Rutgers University Press, 2001. A guide to practical and emotional issues
for caregivers of dementia patients. Chapters provide checklists of topics
that caregivers should deal with or cover as they adjust to their role.
Sharon Wallace Stark
See also: Aging: Cognitive Changes; Alzheimer’s Disease; Brain Structure;
Parkinson’s Disease; Support Groups. 247