World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of Alzheimer's disease and other dementias

Ralf Ihl, Lutz Frölich, Bengt Winblad, Lon Schneider, Alistair Burns, Hans Jürgen Möller

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objectives. To define a practice guideline for biological treatment of dementia and to make transparent the development of the guideline connecting the original data with the resulting recommendations. Methods. This guideline includes pharmacologic treatment considerations for patients with Alzheimer's disease, vascular dementia, DLB, and fronto-temporal dementia. Studies were selected that represent double-blind placebo-controlled trials of at least 3 months duration in patients with a diagnosis of dementia according to accepted international diagnostic criteria (for example the NINCDS/ADRDA or NINDS/AIREN criteria). Moreover, to be included studies had to fulfill a restrictive set of methodological criteria. Original studies and not meta-analyses determined the evaluation and the development of recommendations. Results. Antidementia pharmaceuticals neither cure nor arrest the disease. A modest effect of improvement of symptoms compared with placebo can be observed. Antidementia pharmaceuticals show different efficacy and side effect profiles. The type of dementia, the individual symptom constellation and the tolerability should determine what medication should be used. There are hints that combination therapy of drugs with different therapeutic mechanisms might improve the efficacy. In treating neuropsychiatric symptoms (NPS), psychosocial intervention should be the treatment of first choice. Pharmaceuticals can only be recommended when psychosocial interventions is not adequate. However, even then the side effects of pharmaceuticals limit their use. Conclusions. Depending on the diagnostic entity and the pathology treated different anti-dementia drugs can be recommended to improve symptoms. In the management of NPS, side effects limit the use of medications even when psychosocial interventions have failed. Thus, there is an urgent need to develop more efficacious medications for the treatment of dementia. © 2011 Informa Healthcare.
    Original languageEnglish
    Pages (from-to)2-32
    Number of pages30
    JournalThe World Journal of Biological Psychiatry
    Volume12
    Issue number1
    DOIs
    Publication statusPublished - Feb 2011

    Keywords

    • Alzheimer
    • anti-dementia pharmaceuticals
    • biological
    • Dementia
    • fronto-temporal dementia
    • guidelines
    • Lewy body disease
    • neuropsychiatric symptoms
    • NPS
    • treatment
    • vascular dementia

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