Monday, 18 August 2003: 17:45-19:15
Chicago Sheraton Ballrooms (Sheraton Hotel and Towers)

S105 Clinical Effectiveness of Atypical Antipsychotics in Dementia

The aim of this satellite symposium is to review the efficacy and safety of atypical antipsychotics in the treatment of elderly patients with dementia. The symposium will begin with a scene-setting presentation highlighting the importance of treating the behavioural and psychotic symptoms of dementia using well-tolerated therapies that cause minimal side effects in this vulnerable patient population. This presentation will also discuss key efficacy, tolerability and quality-of-life issues in the treatment of dementia in the elderly, including agitation, psychoses, hypotension, sedation and movement disorders, all of which affect the management of patients. The second presentation will review the efficacy and safety data for atypical antipsychotics in treating the key symptoms associated with dementia, including agitation, psychoses and affective disorders. Optimal dosing of atypical antipsychotics is critical to the effective management of elderly patients to ensure the best possible reduction in symptoms while avoiding the inducement of side effects. This presentation will consider the optimal dosing recommendations across this drug class. Lewy body disease (LBD) is the second most common cause of dementia in the elderly and is frequently associated with psychoses. Patients with this condition are very sensitive to developing extrapyramidal symptoms (EPS) and consequently are particularly vulnerable to side effects caused by conventional antipsychotics. EPS have also been linked with poor medication compliance often resulting in psychotic relapse. Furthermore, the elderly population is also especially susceptible to anticholinergic effects. The third presentation, therefore, focuses on the clinical effectiveness of atypical antipsychotics in the treatment of LBD related psychoses and the need for drugs with a reduced propensity to induce movement disorders. The final presentation highlights the importance of quality-of-life issues in the elderly population. Data suggest that patients who perceive their medication as providing an improved quality of life are more likely to adhere to treatment, which is vital for a favourable therapeutic outcome. In selecting an antipsychotic for use in the elderly, it is important to note that some side effects of antipsychotic treatment, eg EPS, can be as distressing to the patient as the symptoms of dementia. Moreover, some conventional antipsychotics have anticholinergic effects that further impair cognitive function, as do the anticholinergic medications given to alleviate the EPS-related symptoms of some antipsychotics. Thus this section highlights that, in addition to good efficacy and tolerability, any medication should be acceptable to the patient in terms of its effects on quality of life.
Chair:Pierre N. Tariot
 S105-001 The role of atypical antipsychotics in dementia
Brian A Lawlor
 S105-002 Calm and in Control
Pierre N. Tariot
 S105-003 Lewy Body Dementia: The Litmus Test for Extrapyramidal Symptoms
Andrius Baskys
 S105-004 Effectiveness of Antipsychotics: Improving Quality of Life
Clive Ballard

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