Drugs for behavioral and psychological symptoms

2. Behavioural and psychological symptoms in dementia

Behavioural and psychological symptoms are very common in dementia. They usually develop as the person’s condition progresses. They may come and go over time, or they may persist. These changes can be very distressing, both for the person with dementia and those caring for or supporting them. Distressing symptoms may include:

  • Delusions – persistently believing things that are not true, such as that the carer or a family member is an impostor. This may cause the person to feel angry and behave in a hostile way.
  • Hallucinations – seeing or hearing things that aren’t there, such as hearing strange voices. This might make the person with dementia feel afraid and they might act defensively as a result.
  • Agitation and aggressive behaviour – these are sometimes known as ‘behaviours that challenge’ because they are challenging for both the person and those around them.

If a person with dementia develops any of these changes, it is important to remember that they are not to blame or ‘behaving badly’. Their symptoms may be a direct result of changes in their brain, or because of a general health problem such as discomfort caused by pain or infection.

These symptoms can also be related to the care a person is receiving, their environment or how they are spending their time. For example, the person may be agitated because they are anxious or because they are somewhere that is very noisy. Symptoms can become worse because the person’s dementia makes it harder for them to make sense of the world.

There are a number of different ways to relieve behavioural and psychological symptoms in a person with dementia. This factsheet explains the different types of drugs that can be used. However, they shouldn’t be the first thing that is tried. Most behavioural and psychological symptoms improve within four weeks of making simple changes – such as treating pain and spending more time with the person  without the need for medication. These non-drug approaches should generally be tried first.