Use of medication (in dementia)

Agitation, anxiety, wandering, irritability, aggression and similar symptoms are a common problem in dementia, especially once the illness advances. These problems can be the result of the patient's ‘environmental circumstances'. For instance, being either under-stimulated (bored) or over-stimulated.

They may be the result of physical or mental health problems, such as chest or urine infections, constipation or depression. However, they are also often simply a result of the illness. In treating such symptoms, we aim to address underlying problems that are a result of the patient's environment
or health. Sometimes this will result in the symptoms either resolving or improving to a degree where further treatment is not required. At times, it may be necessary to consider the use of medication to treat the symptoms.

This leaflet is primarily intended to inform you about the benefits and possible side effects of such medication.

Side Effects

It is important to be aware that all drugs can have side effects. At the same time, many patients experience no side effects from medication.

Common drug side effects which are shared by many of the drugs we use for treating symptoms of dementia include:

• Drowsiness
• Increased confusion
• Unsteadiness on walking (and risk of falls)
• Stiffness and shaking (tremor)
• Constipation

Few patients will experience more than one of these side effects, and many will have none. Because of the risks (some, e.g. falls, are potentially serious), we will start treatment at a low dose and gradually increase until either the desired effect is achieved or side effects become problematic. We may recommend a trial period of stopping drugs where symptoms have been successfully treated for a few
months. Sometimes the problems re-emerge and treatment needs to be re-started.

The drugs that have been most widely used for these problems are a group known as ‘anti-psychotics'. The use of these medications in people with dementia is associated with an increased risk of death (1 in 100 will be affected). There is also a small chance of a ‘vascular event' in the brain (faints, collapse or stroke). Less than 2 in 100 people will experience this.

Normal life expectancy from diagnosis of dementia to death is 7 years on average. These drugs can significantly improve quality of life in this very disabling and distressing condition. For these reasons careful consideration is given to the benefits and risks of these drugs in individual patients. The decision to use the drug will be under ongoing review and will involve input from your specialist doctor or nurse.

This leaflet is not intended to give detailed information about individual drugs or about non-drug treatments. If you have any further questions, please ask the nurse or doctor involved in your friend / relative’s care or phone tel:01896 827105