| [ Summary ] |
The treatment and management of hemodialysis patients with dementia is an essential subject. Nonpharmacological therapy and social support are important. Pharmacological therapy is also provided in these cases. A type of drug to treat obligatory symptoms of dementia is cholinesterase-inhibitors. To treat BPSD (behavioral and psychological symptoms of dementia), cholinesterase-inhibitors are the first-choice for agitation and restlessness. Second-generation antipsychotics are temporarily used at the same time if symptoms are persistant. Yokukansan may be used as well. When second-generation antipsychotics are used, it is important to pay close attention to deterioration of diabetes mellitus related conditions and QT prolongation. Drugs which should be avoided for treatment of hemodialysis patients with dementia are rivastigmine, memantine, the first-generation antipsychotics, tricyclic antidepressants, benzodiazepines, and drugs excreted by the kidneys. |