PMID- 31607910
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 10
DP  - 2019
TI  - Antipsychotic Treatment of Behavioral and Psychological Symptoms of Dementia 
      (BPSD): Management of Extrapyramidal Side Effects.
PG  - 1045
LID - 10.3389/fphar.2019.01045 [doi]
LID - 1045
AB  - Antipsychotic drugs are often used for the treatment of behavioral and 
      psychological symptoms of dementia (BPSD), especially psychosis and behavioral 
      disturbances (e.g., aggression and agitation). They are prescribed alone or in 
      conjunction with anti-dementia (e.g., anti-Alzheimer's disease drugs) and other 
      psychotropic drugs (e.g., antidepressants). However, antipsychotic drugs 
      frequently produce serious extrapyramidal side effects (EPS) including 
      Parkinsonian symptoms (e.g., bradykinesia, akinesia, tremor, and muscle 
      rigidity). Therefore, appropriate drug choice and combination strategy are 
      important in the treatment of BPSD. Among anti-Alzheimer's disease drugs, 
      cholinesterase inhibitors (ChEIs, e.g., donepezil and galantamine) have a 
      propensity to potentiate EPS associated with antipsychotic treatment in a 
      synergistic manner. In contrast, the NMDA receptor antagonist memantine reduces 
      antipsychotic-induced EPS. Antidepressant drugs, which inhibit 5-HT reuptake into 
      the nerve terminals, also synergistically augment antipsychotic-induced EPS, 
      while mirtazapine (alpha(2), 5-HT(2) and 5-HT(3) antagonist) reduces the EPS 
      induction. Importantly, previous studies showed that multiple 5-HT receptors play 
      crucial roles in modulating EPS associated with antipsychotic treatment. 
      Specifically, activation of 5-HT(1A) receptors or blockade of 5-HT(2), 5-HT(3) 
      and 5-HT(6) receptors can alleviate EPS induction both by antipsychotics alone 
      and by combined antipsychotic treatments with ChEIs or 5-HT reuptake inhibitors. 
      In this article, we review antipsychotic use in treating BPSD and discuss the 
      favorable drug selection in terms of the management of antipsychotic-induced EPS.
CI  - Copyright (c) 2019 Ohno, Kunisawa and Shimizu.
FAU - Ohno, Yukihiro
AU  - Ohno Y
AD  - Department of Pharmacology, Osaka University of Pharmaceutical Sciences, 
      Takatsuki, Japan.
FAU - Kunisawa, Naofumi
AU  - Kunisawa N
AD  - Department of Pharmacology, Osaka University of Pharmaceutical Sciences, 
      Takatsuki, Japan.
FAU - Shimizu, Saki
AU  - Shimizu S
AD  - Department of Pharmacology, Osaka University of Pharmaceutical Sciences, 
      Takatsuki, Japan.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190917
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC6758594
OTO - NOTNLM
OT  - 5-HT receptors
OT  - anti-Alzheimer's disease drugs
OT  - antidepressants
OT  - antipsychotics
OT  - behavioral and psychological symptoms of dementia (BPSD)
OT  - extrapyramidal side effects (EPS)
EDAT- 2019/10/15 06:00
MHDA- 2019/10/15 06:01
PMCR- 2019/09/17
CRDT- 2019/10/15 06:00
PHST- 2019/06/14 00:00 [received]
PHST- 2019/08/19 00:00 [accepted]
PHST- 2019/10/15 06:00 [entrez]
PHST- 2019/10/15 06:00 [pubmed]
PHST- 2019/10/15 06:01 [medline]
PHST- 2019/09/17 00:00 [pmc-release]
AID - 10.3389/fphar.2019.01045 [doi]
PST - epublish
SO  - Front Pharmacol. 2019 Sep 17;10:1045. doi: 10.3389/fphar.2019.01045. eCollection 
      2019.