Pharmacotherapy for dementia
Article information
J Korean Med Assoc. 2018;61(12):758-764
Publication date (electronic) : 2018 December 17
doi :
https://doi.org/10.5124/jkma.2018.61.12.758
Received 2018 November 06; Accepted 2018 November 13.
Abstract
Abstract
Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors—donepezil, rivastigmine, galantamine—and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.
Keywords: Dementia; Pharmacotherapy; Cholinesterase inhibitors; Memantine
Criteria for National Health Insurance coverage in Korea and dose recommendations for acetyl cholinesterase inhibitors and memantine for dementia treatment
General dose recommendations of medications for managing the behavioral and psychological symptoms of dementia
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