Behavioural and psychological symptoms of dementia (BPSD) are a heterogenous cluster of symptoms associated with dementia. They place a significant burden on patients, carers and the health system. BPSD commonly present as apathy and depression, and in more severe cases agitation, aggression and psychosis. Approaches to BPSD management include non-pharmacological and pharmacological treatments. Several classes of medication, including antipsychotic agents, antidepressants, acetylcholinesterase inhibitors and analgesics, may have small but significant effects on BPSD in some patients. However, the side effect profiles of these medications commonly limit their use, and an understanding of their potential for adverse effects coupled with careful ongoing observation is crucial. This review focuses on the pharmacological treatment of BPSD and selection of treatments based on patients' presenting symptoms and expected adverse drug reactions.
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