What Are the Treatments for Dementia-Related Psychosis?

Dementia is a debilitating disease that is heartbreaking not only for the sufferer but for those closest to him, who must watch the mental decay of a loved one. What happens when this degenerative disease adds insult to injury as in the case of dementia-related psychosis?

Early and Intermediate Stages

• There are numerous symptoms and three primary stages of dementia. Symptoms can be highly individualized but the early signs typically include forgetfulness with respect to names and household chores and other familiar routines. Sometimes personality changes such as mood swings, rage and paranoia are observed even in the first stages of dementia.

  When a patient enters the second stage, or the intermediate phase of dementia, more flagrant personality changes are often noted. They may include hallucinations, paranoid delusions, aggressiveness and inappropriate sexual behavior. All these symptoms meet the diagnostic criteria for psychosis. Psychosis is defined as any severe mental disorder in which contact with reality is greatly distorted or entirely lost. Psychotic behavior causes deterioration of normal social functioning.

  The most common delusional symptom for a dementia patient is to believe that someone has stolen her personal belongings, such as a wallet, when in reality the patient forgot where she put the item.

The Final Stage

• By the time a person is suffering from severe dementia, psychotic symptoms have often escalated to the point that the patient is completely reliant on caregivers to provide assistance with daily living.

  According to data from a multicenter study at Columbia University, Johns Hopkins University, and Massachusetts General Hospital, about 15 percent of dementia patients experience paranoid delusions. This does not increase significantly as the severity of the illness intensifies.

Medication Managment

• Since the older antipsychotic medications such as haloperidol can cause numerous side effects, the treatment of choice for many dementia patients with agitation or psychosis is a very low dose of an atypical antipsychotic medication such as isperidone. If after several months the drug has proven effective, a physician may decide that the patient should taper the patient off the medication, since it can contribute to weakened cognition.