What medications are safe and effective for aggressive behavior in patients with dementia?
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Atypical antipsychotic agents (eg, aripiprazole, olanzapine, and risperidone) have been shown to improve some behavioral symptoms, including aggression, in patients with dementia, but also increase mortality compared with placebo. (SOR: A, based on consistent meta-analyses.) Haloperidol decreases aggression in patients with dementia but can cause somnolence, fatigue, and extrapyramidal symptoms. (SOR: A, based on a meta-analysis.) The selective serotonin reuptake inhibitors (SSRIs) citalopram and sertraline improve agitation and psychosis and have been suggested as a safer alternative to antipsychotic agents. (SOR: B, extrapolated from a meta-analysis.)
Evidence Based Practice 15(4): 01-02.