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Current Agents in Development for Treating Behavioral and Psychological Symptoms Associated with Dementia

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Abstract

Behavioral and psychological symptoms associated with dementia are highly prevalent and are associated with an increased risk of institutionalization and mortality. Current pharmacological treatments for these symptoms include cholinesterase inhibitors, antipsychotics, and selective serotonin reuptake inhibitors. When used for treating behavioral and psychological symptoms associated with dementia, they are associated with limited efficacy and/or serious adverse events. As such, there has been extensive research into novel agents with varying mechanisms of action targeting behavioral and psychological symptoms associated with dementia. In this article, we present the results of a comprehensive literature search and review that evaluates current agents that have completed or are currently in clinical trials for treating behavioral and psychological symptoms associated with dementia as a primary outcome. We highlight novel agents from miscellaneous drug classes, such as dextromethorphan/quinidine, bupropion/dextromethorphan, lumateperone, deudextromethorphan/quinidine, methylphenidate and scyllo-inositol, and drugs from various therapeutic classes (including atypical antipsychotics, selective serotonin reuptake inhibitors, and cannabinoids) that have demonstrated promising results and were generally well tolerated. Future research with large appropriately powered studies using validated outcome measures for behavioral and psychological symptoms associated with dementia should be conducted to further establish the clinical utility of these agents.

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Authors and Affiliations

  1. Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Mehnaz Ahmed, Marlene Malik, Johannes Teselink, Krista L. Lanctôt & Nathan Herrmann

  2. Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada

    Mehnaz Ahmed & Krista L. Lanctôt

  3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Krista L. Lanctôt & Nathan Herrmann

  4. Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Krista L. Lanctôt & Nathan Herrmann

Authors
  1. Mehnaz Ahmed
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  2. Marlene Malik
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  3. Krista L. Lanctôt
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  4. Nathan Herrmann
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Corresponding author

Correspondence to Nathan Herrmann.

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No sources of funding were provided for the preparation of this review article.

Conflict of Interest

Krista L. Lanctôt has received research grants from the National Institute of Aging for “Apathy in Alzheimer’s Disease Methylphenidate Trial II (ADMET II)” and “Escitalopram for Agitation in Alzheimer’s Disease (S-CitAD)”, Alzheimer Drug Discovery Fund, the Alzheimer Society of Canada (Grant 15–17), Alzheimer’s Association, Canadian Institutes of Health Research, AbbVie, Lundbeck, Pfizer, Sanofi-Aventis, Janssen-Ortho Inc., Roche, and Wyeth; and honoraria from Abbvie and Lundbeck. Nathan Herrmann has received research grants from the Alzheimer Drug Discovery Fund, the Alzheimer Society of Canada, the National Institutes of Health, Canadian Institute of Health Research, Lundbeck, and Roche; and consultation fees from Lilly, Merck, and Astellas. Mehnaz Ahmed, Marlene Malik and Johannes Teselink declare they have no conflicts of interest relevant to the content of this review article.

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Ahmed, M., Malik, M., Teselink, J. et al. Current Agents in Development for Treating Behavioral and Psychological Symptoms Associated with Dementia. Drugs Aging 36, 589–605 (2019). https://doi.org/10.1007/s40266-019-00668-7

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