Agitation and aggression are common neuropsychiatric symptoms of
Alzheimer’s disease and are highly prevalent in people with dementia. When
pharmacological intervention becomes necessary, current clinical practice guidelines
recommend antipsychotics, cholinesterase inhibitors, and some antidepressants.
However, those interventions have modest to low efficacy, and those with
the highest demonstrated efficacy have significant safety concerns. As a result, current
research is focusing on novel compounds that have different mechanisms of
action and that may have a better balance of efficacy over safety. The purpose of
this review is to evaluate novel pharmacological therapies for the management of
agitation and aggression in AD patients. We performed a comprehensive literature
search to identify recent novel drugs that are not included in most clinical practice guidelines or are
currently undergoing clinical trials for the treatment of agitation and/or aggression in AD. This review
suggests that novel treatments, such as cannabinoids, lithium, non-steroidal anti-inflammatory
drugs, analgesics, narcotics, and newer antiepileptic drugs, may provide a safer alternative treatment
option for the management of agitation and aggression in AD and requires further study in order to
clarify their risks and benefits.
Keywords: Agitation, aggression, Alzheimer’s disease, analgesics, anti-inflammatory drugs, cannabinoids, lithium, narcotics.
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