How best to treat agitation in patients with irreversible dementia?

Abstract

Atypical antipsychotics modestly reduce agitation compared with placebo but have significant adverse effects (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). Haloperidol doesn't reduce symptoms and has serious adverse effects (SOR: A, systematic reviews of RCTs). Selective serotonin reuptake inhibitors (SSRIs) and melatonin--although well tolerated--don't reduce agitation (SOR: B, extrapolated data from systematic reviews of RCTs).