ABSTRACT
A palliative approach, including advance care planning, should be introduced early in those with neurodegenerative disorders. Often the terminal event is an acute episode of sepsis. The newer atypical neuroleptics are preferred. Low-dosage quetiapine or olanzapine are usually tolerated with only minimal neurological adverse reactions. The most effective and safest medication is clozapine, though sedation may be problematic. Irreversible neurological deficits create physical dependency and psychiatric morbidity. The profound neurological sensitivity to antipsychotic medications limits use. Clozapine, the most effective of the antipsychotic medications also has the fewest neurological side effects. Antipsychotic medications risk aggravating the movement disorder. The newer atypical neuroleptics are preferred. Low-dosage quetiapine or olanzapine are usually tolerated with only minimal neurological adverse reactions. Disruption of frontal-temporal circuits by plaques may be the critical organic risk factor for depression, as well as for bipolar mood disorders which have a twofold increased incidence. There are generally a host of psychosocial adversities further enhancing the risk of affective disorder.
