Pharmacotherapy for dementia
10.5124/jkma.2018.61.12.758
- Author:
HyunChul YOUN
1
;
Hyun Ghang JEONG
Author Information
1. Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. jeonghg@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Dementia;
Pharmacotherapy;
Cholinesterase inhibitors;
Memantine
- MeSH:
Acetylcholinesterase;
Activities of Daily Living;
Aging;
Antidepressive Agents;
Antipsychotic Agents;
Cholinesterase Inhibitors;
Cognition;
Dementia;
Drug Therapy;
Estrogens;
Fatty Acids, Omega-3;
Ginkgo biloba;
Glycerylphosphorylcholine;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Korea;
Memantine;
Memory;
National Health Programs;
Public Health;
Rivastigmine;
Vitamin E;
Vitamins
- From:Journal of the Korean Medical Association
2018;61(12):758-764
- CountryRepublic of Korea
- Language:Korean
-
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.