Evidence-based pharmacological treatment of dementia

Abstract

The current literature on the pharmacological treatment of dementia was reviewed and the strength of evidence for the efficacy of each drug was categorized using an evidence-based approach. Acetylcholinesterase-inhibitors represent the only category of drugs with consistently demonstrable efficacy in well-designed studies of Alzheimer's disease, although the effect is not large. There is a lack of prospective, controlled, randomized studies for most of the nootropics. Epidemiological evidence suggests prophylactic effects of oestrogens and anti-inflammatory agents, and a single large-scale trial suggests that long-term administration of vitamin E or selegiline may be associated with improved outcome in patients with Alzheimer's disease. A number of drugs were reported to be effective in the treatment of non-cognitive symptoms of dementia including classical and atypical neuroleptics, antidepressants and anticonvulsants. The evidence for efficacy, however, is not strong for the majority of these compounds.