Hallucinations dementia with Lewy bodies

Dementia with Lewy bodies (DLB) is considered the second most common cause of dementia after AD. The disorder is characterized by progressive fluctuating cognitive impairment, visual hallucinations and motor features of Parkinsonism. Neocoitical cholinergic activity is more severely depleted in DLB than in AD, and DLB also affects the caudate nucleus, the thalamus and the brain stem. Tolerability of ChEI in DLB appears similar to AD, with some gastrointestinal effects and muscle cramps. 

Dementia with Lewy bodies (DLB) is a common neurodegenerative dementia, which mainly occurs in late life (McKeith et al., 1996). The main clinical symptoms include visual hallucinations, parkinsonism and disturbances of consciousness, in the context of a global cognitive dysfunction with prominent... 

May be useful for dementia with Lewy bodies (DLB, constituted by early loss of attentiveness and visual perception with possible hallucinations, Parkinson-like movement problems, fluctuating cognition such as daytime drowsiness and lethargy, staring into space for long periods, episodes of disorganized speech)... 

May decrease delusions, apathy, agitation, and hallucinations in dementia with Lewy bodies... 

Riekse RG, Li G, Petrie EC, Leverenz JB, Vavrek D, Vuletic S, Albers JJ, Montine TJ, Lee VM, Lee M, Seubert P, Galasko D, Schellenberg GD, Hazzard WR, Peskind ER (2006) Effect of statins on Alzheimer s disease biomarkers in cerebrospinal fluid. J Alzheimer Dis 10 399-406 Ridha BH, Josephs KA, Rosser MN (2005) Delusions and hallucinations in dementia with Lewy bodies worsening with memantine. Neurology 65 481 82 Roberts CK, Barnard RJ, Sindhu RK, Jurczak M, Ehdaie A, Vaziri ND (2006) Oxidative stress and dysregulation of NAD(P)H oxidase and antioxidant enzymes in diet-induced metabolic syndrome. Metabolism 55 928—934... 

Dementia with Lewy Bodies (DLB) typically fluctuates visual hallucinations... 

Atypical neuroleptics have a better side-effect profile, and several studies have confirmed their efficacy. Risperidone has been found effective in the treatment of dementia in patients with agitation (N. Hermann et al. 1998 Jeanblanc and Davis 1995 Jeste et al. 1996 I. R. Katz et al. 1999 Lavretsky and Sultzer 1998), in patients with Lewy body disease (Geizer and Ancill 1998), or in patients with L-dopa-induced hallucinations (Meco et al. 1994). Risperidone has better tolerability than classic neuroleptics such as thioridazine and haloperidol (Frenchman and Prince 1997). No studies of the efficacy of olanzapine in the treatment of agitation in patients with dementia have been done, but its use is widely advocated. 

Patients with Lewy body dementia may be more intolerant of neuroleptic drugs, including atypical drugs, than other patients with neurodegenerative dementia. However, because hallucinations are common in this form of dementia, it is likely that people with Lewy body dementia will be exposed to neuroleptic drugs. Two patients with Lewy body dementia taking clozapine developed confusion and behavioral symptoms (227). 

The efficacy and safety of risperidone have been evaluated in 44 patients (25 women and 19 men) with Parkinson s disease (80). There was either complete or near-complete resolution of hallucinations in 23, but an unsatisfactory response (n = 6) or worsening of parkinsonism (n = 6) in 12. Excluding patients with diffuse Lewy body disease, there was no significant worsening of scores on the Unified Parkinson s Disease Rating Scale after either 3 or 6 months of treatment, and the presence of dementia did not predict the response to treatment. 

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