After acknowledging that there are few research studies that show clinicians how to proceed with treatment, Dr. Santulli recommended a rational clinical approach that he said is emerging from the field of geriatric psychiatry. Their answer can provide some clue since people with dementia but no depression generally remain able to enjoy activities, if appropriate to their cognitive level. He noted that families may overrepresent depressive symptoms but recommended that if clinicians are in doubt, it is better to treat for depression because the risk is low and the effect can be great. The basic principles of antidepressant treatment were described as start low, go slow, but go far enough . This physical disturbance is often one of the most serious behavioral difficulties that families face.
Agitation can also have negative effects on people with dementia and their families.
Behavior caused by agitation includes verbal temper outbursts, cursing, and screaming, and less aggressive behaviors such as restlessness and repetitiveness. However, if that method is not effective, an anti-anxiety medication can be used sparingly early in the buildup of tension, or when agitation can be reliably predicted. For agitation that is more continuous, Dr. Santulli recommended several medication possibilities, depending on the situation, including anticonvulsants, SSRI s, and trazodone. The authors emphasize that it can not be assumed that behavior is a symptom of dementia just because the person has been diagnosed with a dementing illnesss. Tariot describes this metaphor as a cluster of the most salient signs and symptoms that are roughly analogous to a drug-responsive syndrome.