Delusional disorder is characterized by the presence of either bizarre or non-bizarre delusions which have persisted for at least one month. In Japan, no medicines are currently licensed for the treatment of the Behavioral and Psychological Symptoms of Dementia (BPSD) in patients with Alzheimerâs disease (AD). Although antipsychotics for BPSD symptoms such as delusions, hallucinations, agitation, or
aggression are prescribed with consent from the legal representatives of AD patients, atypical antipsychotics are avoided because of the increased mortality rate in patients with AD. Brain computed tomography showed the possibility of atrophy of the parahippocampal cortex and a low-density area in the right frontal cortex. The division of AD patients divided into relatively high and relatively low cognitive performance groups, affective disturbance and anxiety were associated with aggressiveness, delusions, and hallucinations in the latter group this indicated that AD progression also affected BPSD, connecting psychotic and depressive symptoms. On the basis of these assertions, physicians should prescribe augmentation medications for BPSD. However, the oldest old are more vulnerable to the adverse effects of antipsychotics, which should therefore be avoided for these patients.
Last date updated on April, 2021