While many people are familiar with the ways that dementia can disrupt memory, communication and thinking, dementia-causing diseases like Alzheimer's also cause a number of mental health symptoms. According to a 2009 article appearing in Psychiatric Times, as many as 70 percent of people with some sort of dementia also experience an anxiety disorder over the course of their disease. Treatment options are available to manage the anxiety, which may bring much-needed relief to patients and caregivers alike.
SSRIs
A class of antidepressants referred to as selective serotonin reuptake inhibitors, or SSRIs, are often used to treat anxiety in older dementia patients who require it for long-term use, according to the "Treatment of Dementia and Agitation: A Guide for Families and Caregivers," published by the UC Davis Alzheimer's Disease Center. These medications can include Lexapro, Prozak, Pakil and Zoloft. The Alzheimer's Association reminds patients and caregivers that no medications have been specifically approved by the U.S. Food and Drug Administration to treat behavioral or psychiatric symptoms related to dementia, which means that the exact dosages are not known, nor are the potential side effects or long-term effects.
Benzodiazepines
A class of anti-anxiety medications known as benzodiazepines are used to treat anxiety in dementia patients, but according to the UC Davis Caregiver Guide, they are only recommended for short-term use or atypical antipsychotic behaviors. While benzodiazepines can take effect quickly, they can also be habit-forming and cause heavy sedation or drowsiness. Even single doses, the UC Davis guide reports, can cause unsteady gait and interfere with memory. Preferred benzodiazepines include Ativan and Serax, whose contents appear to clear quickly from the body. Other benzodiazepines like Dalmane and Klonopin tend to stay in one's system longer and are therefore more apt to cause daytime sedation.
Behavioral Approaches
The Alzheimer's Association advises caretakers to help mitigate anxiety symptoms by trying to understand its underlying cause. Once this is identified, the caretaker should then modify the patient's environment to remedy the situation. Dementia patients often experience anxiety after a change in living arrangements, changes in routine that include everything from travel to the presence of house guests. Efforts to simplify routines as well as the environment are often met with a reduction in anxiety.
Cognitive behavioral therapy may also help minimize anxiety in dementia patients, according to the results of two case studies summarized at PubMed.gov. Conducted in May 2008 by Kraus, Seignourel, et al at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, the two patients that received modified behavioral therapy experienced dramatic drops in their Clinical Dementia Rating Scale scores. While the authors agreed the study was limited, they concluded their technique merited further study.
References
- Psychiatric Times: Comorbidity: Psychiatric Comorbidity in Persons With Dementia
- UC Davis Alzheimer's Disease Center: Treatment of Dementia and Agitation: A Guide for Families and Caregivers
- PubMed.gov: Cognitive-behavioral Treatment for Anxiety in Patients With Dementia: Two Case Studies
- Alzheimer's Association: Behavioral Symptoms
