Lewy body dementia treatment
How is Dementia by Lewy Bodies treated?
ADementia by Lewy Bodies (DLB) has a very complex treatment, due to several factors.
The first reason is due to the multiple symptoms that occur, from motor symptoms, such as slow movement, falls, rigidity, in addition to cognitive symptoms, leading to dementia, usually at the beginning of the disease, and psychiatric symptoms, with changes in behavior, hallucinations and sleep disorder.
The second and important reason is that a characteristic of the disease is hypersensitivity to some medications that are normally used.
In this way, medications can have exaggerated effects and may not help (and sometimes they get in the way!). So the treatment must be measured and in short steps.
And finally, we must remember that there is no specific medicine for the disease, capable of preventing the progression of the disease. Thus, we treat the symptoms as they appear.
The treatment of Dementia by Lewy Bodies is extremely complex, and must be approached in a multidisciplinary way, with physical, psychological, environmental and cognitive stimuli.
How to treat the symptoms of Lewy Body Dementia?
Once symptoms appear, treatment must address the symptoms specifically, always remembering to individualize treatment and adjust over time.
Motor symptoms (slowness of movement, stiffness, falls):It is common to use drugs similar to those used in Parkinson's disease, such as Prolopa (Levodopa/Benserazide); Pramipexole, Azilect, among others. Many of these medications can make the psychiatric part worse, worsening behavior or hallucinations, and so we often have to adjust, decreasing or even withdrawing these medications.
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Insanity: Medicines similar to those used in Alzheimer's Disease may be useful, such as Donepezil, Rivastigmine, Galantamine and Memantine. These medications tend to be mostly helpful early on and may help with behavior as well. As the disease progresses, they may not have the desired effect in moderate or advanced stages.
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Hallucinations: They must be addressed when they lead to an impact on the patient or caregivers. The main drugs used are antipsychotics, however these drugs can lead to the worsening of other symptoms and must be used with great care and almost always in very low doses when really necessary.
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Behavior change: Treatment is also challenging, as mentioned above, the patient may have a much higher than normal sensitivity to medications that are normally helpful, such as Quetiapine and Clozapine. Non-drug treatments with music therapy, manual work, physical activities can be very useful.
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Phantom symptoms such asunexplained pain, itching for no reason, symptoms of "shortness of breath", are extremely common and can happen early in the disease.It is usually investigated initially to rule out organic causes. But investigations usually do not reveal any abnormality, leading to the conclusion that the symptoms are of a cognitive or psychological nature. The treatment must be carried out in the same way, initially with non-drug treatment,_cc781905-5cde-3194 -bb3b-136bad5cf58d_when possible .