Managing Dementia Symptoms

which include aggression, delusions, hallucinations, apathy, anxiety, and depression, can be difficult to treat and are usually managed with various psychotropic drugs.

In this study, a physician assistant ruled out and treated any reversible causes of BPSD, such as pain and infection. The nurses then tried nonpharma-cological approaches. If the patient did not respond and the staff judged it appropriate to try drug therapy, they consulted the clinical pharmacists. The pharmacists worked with the staff to design a pharmacotherapy plan, wrote the orders, monitored progress and any side effects, and adjusted doses.

The drugs were selected on the basis of the patients’ most troublesome symptoms. The most commonly targeted symptoms were physical and verbal aggression, delusions, sleep disturbances, anxiety, and depression. Only two of the 11 patients had received psychotropic drugs before the study. During the study, the most commonly administered drug was medication trazadone (Desyrel drug, Bristol-Myers Squibb), to which all but two patients responded. Quetiapine drug fumarate (Seroquel medication, Astra-Zeneca) and generic  sertraline (Zoloft tablet, Pfizer) were prescribed for these two patients, and they responded favorably.

Overall, the pharmacist-managed consultation service was well received, and treatment was efficient and successful. However, the researchers noted a few kinks in the process. One problem was the use of different terminology to describe the same symptoms. “Agitated,” they point out, can mean anything from restlessness to physical aggression, and treatment can vary correspondingly.