Analgesics in the management of behavioral and psychological symptoms of dementia: a perspective review

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Abstract
The objective of this review was to assess the efficacy and tolerability of analgesics in reducing behavioral and psychological symptoms of dementia (BPSD) among older adults from published randomized controlled trials (RCTs). A literature search was conducted of PubMed, MEDLINE, SCOPUS, PsycINFO, and Cochrane collaboration databases for RCTs in the English language that evaluated the use of analgesics in reducing the severity of BPSD among older adults. Additionally, references of full-text articles that were included in this review were searched for extra studies. We identified a total of three unique RCTs that evaluated the use of analgesics among individuals with BPSD. One of the identified RCTs resulted in a total of three additional published papers in the literature, resulting in a total of six papers to be included in this review. All three RCTs identified some benefit for the use of analgesics in reducing BPSD. The analgesics appeared to be well tolerated in the included studies. Major study limitations include the use of data exclusively from published RCTs and limiting the search to English language publications. Additionally, we did not utilize statistical methods to evaluate the treatment outcomes including tolerability. In conclusion, available evidence although limited indicates that analgesics may reduce BPSD among some individuals with dementia living in nursing homes and are well tolerated.

Keywords: dementia, review, psychopharmacology, pain, analgesics, aggression, neuropsychiatry, elderly.

Citation: Tampi RR, Hassell C, Joshi P, Tampi DJ. Analgesics in the management of behavioral and psychological symptoms of dementia: a perspective review. Drugs in Context 2017; 6: 212508. DOI: 10.7573/dic.212508

Contributions: All authors contributed equally to the development and writing of this manuscript.

Declaration of potential conflicts of interest: The authors have no conflicting interests to declare. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at: http://www.drugsincontext.com/wp-content/uploads/2017/11/dic.212508-COI.pdf

Copyright: Copyright © 2017 Tampi RR, Hassell C, Joshi P, Tampi DJ. Distributed under the terms of the Creative Commons License Deed CC BY NC ND 4.0, which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2017 Tampi RR, Hassell C, Joshi P, Tampi DJ. https://doi.org/10.7573/dic.212508. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: http://www.drugsincontext.com/analgesics-in-the-management-of-behavioral-and-psychological-symptoms-of-dementia-a-perspective-review

Correspondence: Rajesh R Tampi, MD, MS, DFAPA, Department of Psychiatry, MetroHealth, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. rajesh.tampi@gmail.com

Provenance: invited; externally peer reviewed.

Submitted: 11 September 2017; Peer review comments to author: 28 September 2017; Revised manuscript received: 17 October 2017; Accepted: 17 October 2017; Publication date: 22 November 2017.

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