Psychological, behavioural and psychosocial interventions for neuropsychiatric symptoms in dementia: What works, what does not and what needs more evidence?

Neuropsychiatric symptoms occur in clusters and the most commonly dened clusters are agitation, psychosis and mood disorder (Ballard et al., 2008). ey may have

dierent aetiologies (Bruen et al., 2008) and require different management. Neuropsychiatric symptoms are oen treated with psychotropic medications (see Chapter 25). ere are major concerns about their safety, particularly antipsychotics (Schneider et al., 2005) and also citalopram (Porsteinsson et al., 2014), and ecacy (antipsychotics, memantine, carbamazepine and cholinesterase inhibitors) (Trinh et al., 2003; Schneider et al., 2006; Howard et al., 2007; Fox et al., 2012). Guidelines, therefore, recommend non-pharmacologic strategies as the preferred rst line treatment approach (except where there is imminent danger or safety concerns) (National Institute for Clinical Excellence [NICE], 2006; Kales, 2015).