There are no treatments specifically for DLB and, at present, there is
no cure. Medications will depend on
individual symptoms and must be closely monitored by an experienced
professional as some can cause unwanted side effects and worsen symptoms. Sometimes altering the dosage of an existing
medication or stopping it can help, rather than introducing a new one.
Neuroleptics/antipsychotic
medications
Some of the older antipsychotic or neuroleptic medications, which might
be prescribed for other types of dementia, should be used cautiously or, better
still, avoided as people with DLB are often more sensitive to them. Use of
these drugs may cause rapid worsening in symptoms or, in extreme cases, even
death. They should therefore be taken
with caution and their use should be monitored by an experienced professional
such as a neurologist or psychiatrist.
Some of those that should be avoided are:
- Clopixol (Clopenthixol)
- Dolmatil, Sulparex, Sulpatil
(Sulpiride)
- Haldol, Serenace (Haloperidol)
- Largactil (Chlorpromazine)
- Modecate (Fluphenazine)
- Sparine (Promazine)
- Stelazine (Trifluoperazine).
If a neuroleptic is required to control troublesome symptoms such as
visual hallucinations, then a newer ‘atypical’ type may be prescribed as they
have fewer side effects, but they must still be used with caution and only when
monitored by an experienced professional such as a neurologist or
psychiatrist. Some of those that might
be considered are:
- Risperdal (Risperidone)
- Seroquel (Quetiapine)
- Zyprexa(Olanzapine)
Acetylcholinesterase
inhibitors
Research suggests that some of the new anti-dementia drugs
(acetylcholinesterase inhibitors) may be helpful in reducing memory problems,
confusion and hallucinations, although they may worsen other symptoms such as
falls. It must be remembered that they
are not yet officially recommended for treating DLB but they may be helpful in
some cases when cognitive problems cause considerable distress. Some of those that may be considered are:
- Aricept (donepezil hydrochloride)
- Exelon (rivastigmine)
- Reminyl (galantamine).
Dopamine related
medications
If motor symptoms are troublesome then standard anti-Parkinsonian dopamine replacement
medications such as levodopa can be helpful.
But individual responses vary and they are generally not as effective as
when used to treat Parkinson’s. Some
people experience a worsening of symptoms such as confusion and hallucinations,
so they are not suitable for everyone and their use should be monitored
closely.
In some cases a combination of Alzheimer’s medications together with
Parkinson’s medications can be helpful but an experienced doctor will need to
work with you in order to achieve an optimal balance.
Non-medical
treatments
There are a number of other ways to reduce symptoms and improve quality
of life such as keeping to a regular routine, using memory aids such as lists
and calendars, improved lighting, visual stimulation and art therapy, and music
therapy. Research is also being carried out into the benefits of aromatherapyand the use of
essential oils.
A supportive environment is also important, and a flexible daily
routine that can accommodate the fluctuations in symptoms and cognitive
abilities that occur.
