Good Intentions, But What About Unintended Consequences?
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The greatest thing that science teaches you is the law of unintended consequences.
- Ann Druyan
Managing the behavioral and psychological symptoms of dementia (BPSD) that accompany cognitive decline—including agitation, anxiety, depression, aggression, sleep problems, and socially inappropriate behaviors—is one of the biggest challenges of day-to-day care. These symptoms are associated with many of the negative outcomes of dementia, including hospitalizations; increased placement in nursing homes; caregiver stress, including depression and lost income; and decreased quality of life for both patient and caregiver. Despite the fact that, in the USA, no drugs have been approved by the US FDA for BPSD, the current mainstay of treatment is the (primarily off-label) use of psychotropic medications [1, 2]. Of the agents used to treat BPSD, atypical antipsychotics have the strongest evidence base, although their benefits are moderate at best (effect size 0.13–0.16) . Any such benefits must...
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No sources of funding were used to assist in the preparation of this commentary.
Conflicts of interest
Helen Kales and Donovan Maust have no conflicts of interest that are directly relevant to this commentary.
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