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Review
. 2019 Aug 8;21(8):79.
doi: 10.1007/s11920-019-1058-4.

Advances in Management of Neuropsychiatric Syndromes in Neurodegenerative Diseases

Jeffrey Cummings  1   2 , Aaron Ritter  3 , Kasia Rothenberg  4
Affiliations
Review

Advances in Management of Neuropsychiatric Syndromes in Neurodegenerative Diseases

Jeffrey Cummings et al. Curr Psychiatry Rep. .

Abstract

Purpose of review: Neuropsychiatric syndromes (NPS) are common in neurodegenerative disorders (NDD). This review describes the role of NPS in the diagnosis of NDD, criteria for the diagnosis of NPS, management of NPS, and agents in clinical trials for NPS.

Recent findings: NPS play an increasingly important role in the diagnosis of NDD. Consensus diagnostic criteria have evolved for psychosis, depression, agitation, and apathy in NDD. With one exception-pimavanserin is approved for the treatment of hallucinations and delusions in Parkinson's disease-there are no drugs approved by the FDA for treatment of NPS in NDD. Trials show that atypical antipsychotics reduce psychosis in AD and in Parkinson's disease, although side effect concerns have constrained their use. Antidepressants show benefit in treatment of Parkinson's disease with depression. Several agents are in clinical trials for treatment of NPS in NDD. Neuropsychiatric syndromes play a major role in NDD diagnosis. Clinical criteria allow recognition of NPS in NDD. Psychotropic medications are often useful in the treatment of NPS in NDD; efficacious, safe, and approved agents are needed.

Keywords: Agitation; Alzheimer’s disease; Apathy; Depression; Neurodegenerative disorders; Neuropsychiatric syndromes; Parkinson’s disease; Psychosis.

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Conflict of interest statement

Aaron Ritter and Kasia Rothenberg each declare no potential conflict of interest.

Jeffrey Cummings has provided consultation to Acadia, Accera, Actinogen, ADAMAS, Alkahest, Allergan, Alzheon, Avanir, Axovant, Axsome, BiOasis Technologies, Biogen, Bracket, Eisai, Genentech, Global Alzheimer Platform, Grifols, Kyowa, Lilly, Lundbeck, MedAvante, Merck, Neurocog, Nutricia, Otsuka, QR Pharma, Resverlogix, Roche, Samus, Servier, Suven, Takeda, Toyoma, and United Neuroscience companies. JLC owns stock in ADAMAS, Alzheon, BiOasis, EIP Pharma, Prana, Sonexa, MedAvante, Neurotrax, and QR Pharma. JLC receives research support from Avid and Teva. JLC owns the copyright of the Neuropsychiatric Inventory (NPI).

Figures

Fig. 1
Fig. 1
Serial parallel comparative design (SPCD). Placebo non-responders are re-randomized to drug or placebo
See this image and copyright information in PMC

References

    1. Aalten P, de Vugt ME, Lousberg R, Korten E, Jaspers N, Senden B, Jolles J, Verhey FRJ. Behavioral problems in dementia: a factor analysis of the neuropsychiatric inventory. Dement Geriatr Cogn Disord. 2003;15(2):99–105. doi: 10.1159/000067972. - DOI - PubMed
    1. Boccardi V, Conestabile Della Staffa M, Baroni M, Ercolani S, Croce MF, Ruggiero C, Mecocci P, ReGAL study group Prevalence and correlates of behavioral disorders in old age subjects with cognitive impairment: results from the ReGAl Project. J Alzheimers Dis. 2017;60(4):1275–1283. doi: 10.3233/JAD-170494. - DOI - PubMed
    1. Poletti M, Nuti A, Cipriani G, Bonuccelli U. Behavioral and psychological symptoms of dementia: factor analysis and relationship with cognitive impairment. Eur Neurol. 2013;69(2):76–82. doi: 10.1159/000341956. - DOI - PubMed
    1. Beeri MS, Werner P, Davidson M, Noy S. The cost of behavioral and psychological symptoms of dementia (BPSD) in community dwelling Alzheimer’s disease patients. Int J Geriatr Psychiatry. 2002;17(5):403–408. doi: 10.1002/gps.490. - DOI - PubMed
    1. Herrmann N, Lanctot KL, Sambrook R, Lesnikova N, Hebert R, McCracken P, et al. The contribution of neuropsychiatric symptoms to the cost of dementia care. Int J Geriatr Psychiatry. 2006;21(10):972–976. doi: 10.1002/gps.1594. - DOI - PubMed

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