Anxiety,Aggression,Hostility: Treatments For In Alzheimer's Disease
A number of drugs and compounds
have been used with varying effectiveness for the treatment of agitation and
anxiety in alzheimer patients. Haloperidol or thioridazine have been widely used
to control agitated patients. Both seem to work equally well, but haloperidol
seems to cause more parkinson-like side effects,known as extrapyramidal symptoms
. Some studies have shown the haloperidol more effectively controls
agitation when combined with other agents. For example, one study reports that
carbamazepine and haloperidol controls agitation better than haloperidol by
Sometimes, behavior management techniques can
control agitation. A very recent study finds that proper behavior managament by
staff is just as effective in controlling agitation as haloperidol or trazodone
. What are behavior management techniques? When you have an anxious or
agitated person, try to use some of the following techniques:
1. Approach the
patient in a gentle,calm manner.
2. Always try to orient a patient to his/
3. Use the patient's name frequently.
4. Approach patient from
the front, not the side.
5. Reassure the patient that you understand their
6. Don't tell patients what they should not do; instead focus on
what they should do. For example, don't say:"Don't go outside", but do
say:"Please stay inside".Patients find it easier to understand a simple command.
Some antidepressant compounds of the benzodiazepine class,
such as trazodone, are quite effective at reducing agitation in alzheimer
patients [23-24]. Twenty five milligrams,given three times daily, seems to
decrease anxiety . The major side effect at higher doses is dry
Other less- used compounds have been shown to
control agitation,sometimes when nothing else seems to work. Phosphatidylserine,
sold in health food stores, decreases anxiety . Propanolol, in daily doses
from 10 to 80 milligrams daily, can control aggression in highly aggressive
patients even after two weeks . Medroxy-progesterone acetate,an
anti-androgen, completed stopped all physical and verbal aggression in 3
demented patients with extremely high aggression and hostility .
Some drugs can actually increase hostility in alzheimer
patients. Scopolamine, a cholinergic blocker, increases hostility more in
alzheimer patients than in non-demented controls .
Some drugs decrease anxiety, but come with additional costs to the patient.
Benzodiazepines have been widely used to control anxiety. Diazepam is one drug
in the benzodiazepine class. Benzodiazepines can actually worsen cognitive
abilities [30-31] and increase the risk of falls [32-33]. Alzheimer patients,as
you may know, are more prone to falls because of a slowed gait and poor