By switaschek, 13 July, 2020 Don't use thioridazine, chlorpromazine, or trazodone for behavioral/psych sx, per WHO;3 (CCC considers role of trazodone, quetiapine, SSRIs uncertain for agitation5). If no delirium, don’t use haloperidol 1st line.2 Don’t use valproate for agitation/aggre
By switaschek, 13 July, 2020 Drug options. Start low, titrate to min effective dose.2 Consider aripiprazole, olanzapine, risperidone1 for severe agitation, aggression, psychosis w/ risk of harm to pt/others. Carbamazepine may help aggression1
By switaschek, 13 July, 2020 Antipsychotics: Use only if sx severe, dangerous, or significantly distressing to pt, after discussing risk/benefit, per APA;2 use only if unresponsive to non-drug tx & cholinesterase inhibitors, per EFNS.1 WHO prefers specialist input when using antipsyc
By switaschek, 13 July, 2020 For agitation/psychosis/aggression: Use non-drug tx 1st, d/t significant risks w/ antipsychotics4
By switaschek, 13 July, 2020 Major depressive disorder/severe depression or if non-drug tx fails: Consider antidepressant trial;5 use SSRIs, not TCAs,3 which may have adverse anticholinergic effects1
By switaschek, 13 July, 2020 Mild-to-mod depression in dementia: WHO recommends offering cognitive behavioral tx, interpersonal tx, structured counseling, etc; antidepressants aren’t 1st line3