Buspirone for Stereotypic Movements in Elderly With Cognitive Impairment

Abstract

Repetitive and stereotypic behavioral disturbances in patients with dementia are common; however, little is known regarding successful treatments. The authors describe six cases of elderly cognitively impaired patients exhibiting repetitive and stereotypic behaviors who were treated successfully with buspirone. The cases demonstrate that buspirone may be an effective and safe treatment for patients with dementia who demonstrate repetitive and stereotypic behavior disorders.

Repetitive and Stereotypic Phenomena and Dementia

“…5,6 These phenomena may include simple motor movements such as patting, rubbing, scratching, picking, placing nonfood items in the mouth, or verbalizations that can include counting or repetitive sounds. 7 Impulse control disorders (pathological gambling, intermittent explosive disorder, pyromania, kleptomania, trichotillomania, etc) are not considered as stereotypic behavior because they constitute a pattern of voluntary behaviors. The RBs are described in individuals with autism spectrum disorders, and they are a common feature of a number of other neurodevelopmental disorders (eg, Rett, Fragile X, and Prader–Willi syndromes).…”

“…Trappler and Vinuela 56 described the effects of treatment with the selective serotonin reuptake inhibitor fluvoxamine in 3 patients with advanced dementia who developed a stereotypic movement disorder; two patients showed complete resolution of their stereotypic behaviors, and the third patient showed noticeable improvement with some residual movements after 8 weeks of treatment. Helvink and Holroyd 7 observed 5 cases of elderly patients with cognitive impairment (2 patients with AD, 2 with vascular dementia, and 1 with dementia due to alcoholism) exhibiting repetitive and stereotypic behaviors who were treated successfully with buspirone. It is possible that, as a 5-HT1A antagonist, buspirone works through a serotonergic mechanism to decrease these behaviors.…”