Pharmacological treatment of behavioral and emotional symptoms of Alzheimer’s disease: a case for polypharmacy

Abstract

SUMMARY Behavioral and emotional symptoms are common in Alzheimer’s disease, but often present treatment dilemmas because there are no US FDA-approved treatments for these symptoms, with the exception of treating depression and mania. A common axiom in geriatric psychopharmacology is to avoid polypharmacy so as to minimize drug–drug interactions and side effects. However, there may be rationale for simultaneous use of one or multiple classes of medications, for example, to minimize side effects by giving two or more medications at lower doses to reduce the potential side effects of larger doses of the individual drugs. Symptom clusters can also be targeted by combining medications such as a cholinesterase inhibitor with an antipsychotic, an antipsychotic with an antidepressant or an antidepressant with a hypnotic drug.