IS 8 July 2001
sleeping tablets, tranquillisers and anti-depressants
With the advent of the ‘anti-dementia’ compliance with medication a problem tranquillisers and anti-depressants, used she is behaving in a disturbed fashion, or behaviour problems that arise during the her wishes. Doctors are expected to take information sheet briefly describes these for giving a drug without the person’s to consult a specialist or even consider Reasons for treatment
Treating people with dementia
used, the doctor will be more cautious in an older person, probably starting from a Information Sheet the dose, making sure that the person is hopes will be improved by the drug. tolerating each level before any increase. reasonable to try a course of an anti-depressants if a person goes to the The principal use of sleeping tablets in dementia is when the person has got into times, or has ‘sleep reversal’ – up at (Zimovane), zolpidem (Stillnoct), temazepam and chlormethiazole and the drug clonazepam (Rivotril) may be especially helpful. Poor sleep is also doctors prefer to use anti-depressants to problem, for it may be due to some other constipation causing restlessness, or pain Anti-depressants
be reacting to the dementia or to his or when the person has a significant degree of depression in addition to the changes different chemical systems in the brain. situation without recourse to drugs. For helping. The tricyclic drugs like amitriptyline (Tryptizol) and dothiepin (Prothiaden) are less used now than in blood pressure, and effects on the heart, Hypnotics or sleeping tablets
Lofepramine (Gamanil) is one of the they lose their effect and the person may depressants nowadays are the SSRIs (selective serotonin reuptake inhibitors), such as fluoxetine (Prozac), sertraline (Lustral), citalopram (Cipramil) and paroxetine (Seroxat). They are less Anti-psychotic drugs (neuroleptics or
likely to have the above side-effect, but major tranquillisers)
neuroleptics or major tranquillisers are including restlessness, irritability and nefazodone (Dutonin) and trazodone (Molipaxin). St John’s Wort, a herbal medicine, is increasingly being used for last resort, after non-drug methods have and a variety of neurological side effects by a fit of tears, or laughter or irritation, SSRI drugs, particularly fluoxetine may Antidepressants, especially the SSRIs and trazodone, have also been used in as if the patient is getting worse rather than better, so the doctor is tempted to increase the drug further when he should obsessional thoughts. Trazodone has In the past thioridazine (Melleril) was Anti-anxiety drugs or anxiolytics
other side effects. Thioridazine is no as diazepam, lorazpam or oxazepam are occasionally needed, but they should not be used for longer than a few weeks, for doctor and/or a specialist. Other similar interfering with his or her ability to carry promazine (Sparine) which is relatively mild in action, haloperidol (Serenace or Haldol) and droperidol (Droleptan), urgent situations, pimozide, which needs tranquillisers, but their effects are likely careful monitoring to avoid side effects on the heart and sulpiride (Dolmatil). dementia they may be used to try to deal psychotics, especially risperidone (Risperdal) and olanzapine (Zyprexa). These seem to be quite effective in some patients in calming restlessness and have persistent restlessness by night and day, severe aggression to others or repetitive ‘typical’ drugs, but this does not mean shouting. The use of the anti-depressant trazodone has already been mentioned. Olanzapine can make patients put on Carbamazapine (Tegretol) and sodium weight. Risperidone can cause sedation valproate (Epilim) are anti-epileptic effectively in relatively small doses, and there is usually little point increasing the if the person is not giving any indication loss of control over sexual behaviour in delusions, the ‘psychotic symptoms’ of men leads to the use of cyproterone case. However, they are not safe for
patients who have Lewy body
But in these and in all cases of behaviour dementia. Even small doses used to
and doctors and other professionals need neurological effects including stiffness and unsteadiness. It has been found that anticholinesterases such as donepezil, rivastigmine and galantamine can not Other drugs
Note: In this information sheet the
‘proper’ chemical name of the drug is given first. Proprietary names given by particular drug companies are put in brackets.

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