Psychosis is a common and difficult to treat symptom in Alzheimer’s
disease (AD) patients. For the treatment of psychosis symptom and disruptive
behaviors in AD patients, antipsychotics (APs) have been recommended. In this
chapter, we reviewed clinical studies with AD patients who were treated by either firstor
second-generation antipsychotics (FGAs or SGAs). FGAs showed overall
disappointing results in elderly dementia patients, while adverse events occurred
frequently, especially motor side effects, sedation, and cognitive impairment. SGAs
offer an advance for the management of aggression and psychosis in the context of
dementia. Although some of previous studies reported higher mortality in AD patients
treated with SGAs, the others described no risks of mortality, even protective effects of
them in AD patients. Preclinical studies indicate that early, low-dose and long-term
administration of some SGAs may improve behavioral symptoms in various animal
models of AD while attenuating pathological changes in the brain. The protective
effects are achieved through inhibiting the pathological processes of oxidative stress
and neuroinflammation of AD, in addition to the neurotrophic action of SGAs. All
these protective actions can be hardly explained by the differential affinities of SGAs to
multiple neurotransmitter receptors in the brain. Further studies are required to
elucidate the molecular basis of these actions.
Keywords: Alzheimer’s Disease, Antipstchotics, Anti-Inflammation,
Antioxidatant, Behavioral, Cognitive Impairment, Mortality, Neuroprotection,
Psychiatric Disturbances.
