Abstract

Dementia is one of the most common neurodegenerative disorders that annually affects over 55 million people worldwide; behavioral and psychological symptoms of dementia (BPSD), including anxiety, aggression, and depression, reduce the quality of life. The pharmacological interventions applied as a treatment of BPSD comprise antipsychotics, antidepressants, and sedatives. They include serious side effects such as increased mortality risk, cognitive impairment, and extrapyramidal syndromes. Moreover, the type of treatment applied must address the patient’s needs. Evidence suggests that a patient’s response to the medications might differ depending on the general health status, age, and the type of dementia present. An analysis of scientific articles included a systematic search in the PubMed database for articles published between the years 2018 and 2024. The search identified 93 papers pertinent to the pharmacological interventions of BPSD, where keywords were “antipsychotics,” “antidepressants,” “outcomes,” and “side effects.” The medications’ effectiveness and safety were evaluated, in addition to concerns in elderly patients. Pharmacological interventions vary in efficacy, with atypical antipsychotics being moderately effective but linked to significant side effects, including metabolic disturbances and cardiovascular risks. The treatment selection must consider the patient’s clinical profile, underlying dementia type, and potential drug interactions. Careful monitoring and individualized treatment plans are crucial, especially for elderly patients at higher risk of adverse outcomes. Although treatments with antipsychotics and other relatively safe drugs might reduce the symptoms of BPSD, their usage should be guarded given the side effects, especially in frail elderly patients.

Key words: Behavioral and psychological symptoms of dementia, pharmacological treatments, antipsychotics, antidepressants, side effects