Management of Agitation in Dementia

Efficacy of Antipsychotics

• The benefits of antipsychotic medications for agitation in dementia are at best small when assessed through clinical trials, with a standardized mean difference of -0.21, indicating a slight reduction in agitation 1, 2

Preferred Treatment Approach

First-Line: Non-Pharmacological Interventions

• Always assess and implement non-pharmacological interventions before considering any medication, including evaluating for potentially reversible factors contributing to agitation and implementing structured activities and support for family and caregivers 3

Alternative Pharmacological Options

• SSRIs are considered first-line pharmacological treatments for agitation in dementia, and serotonergic antidepressants significantly improve overall neuropsychiatric symptoms, agitation, and depression in individuals with dementia 4

Monitoring and Follow-up

• If an antipsychotic is used, monitor for cognitive worsening 4