This month is Mental Health Month so I thought it would be good to look at drugs used to treat agitation and psychosis, what you should expect from this type of medication and when you need to get more help. Agitation

is seen in about 60 to 80 percent of people with Alzheimer's disease and psychoses around 35 to 50 percent. Medications are often used to treat behavioral disturbances associated with agitation and paranoia seen in the moderate stage of Alzheimer's disease.

Finding the Correct Drug and Dosage

Caregiver information is central to monitor drug effectiveness.

 When a doctor prescribes drugs he should have already:

• made a thorough assessment of the patient.
• have treated or be treating any reversible medical problems they have and that may be contributing to their psychiatric condition, and
• implemented any behavioural programes and considered environmental issues contributing to the situation.

The doctor needs to prescribe the appropriate drug, find the correct dosage and prevent or minimize any drug interactions or side effects from it.

The role of the caregiver is pivotal to getting the best results. The doctor cannot be with his patient 24/7 so the caregiver needs to report back to the doctor the positive and negative effects the drug/drugs they are taking.

Medications for Agitation, Psychosis and Alzheimer's

There are many different forms of medication available that can be used to treat agitation but only antipsychotic agents are used to treat psychosis. Potential agents include:

Anxiolytics; Examples are Lorazepam (Ativan), Alprazolam (Xanax), Oxazepam (Serax).

Antidepressants;

Betablockers;

Acetylcholinesterase inhibitors

Drugs used to treat Alzheimer's disease can also help with agitation. They include Donepezil (Aricept), Rivastigmine (Exelon), Tagrine (Cognex), Reminyl.

Mood stabilizers-Examples include Carbamazipine (Tegretol), Divalproex (Depakote)

Antipsychotics- Examples are Haloperidol (Haldol) and atypical types of medication such as Clozapine (Clozaril), Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (seoquel)

Guide to Antipsychotic Medications and Alzheimer's

Age Affects How Drugs Work

There are a number of reasons why drugs work differently and make older people more prone to adverse reactions to them. 

Drug Interactions:

Elders experience more adverse drug reactions for a number of reasons. Older people get more diseases and often have multiple diseases. Receiving all sorts of different drugs for different illnesses at one time makes it more likely that they will suffer adverse drug interactions.

Body changes of advancing age affect drug distribution and metabolism. This can lead to drug toxicity at doses that are therapeutic for younger people. Elders often have smaller body sizes so that common prescription doses can be more toxic to them. Total body water decreases with age by as much as 15 percent making a difference to blood concentrations. A number of studies have shown that reduced absorption of nutrients can affect drug absorption although no clinically significant decreases in drug absorption resulting from normal aging have been recognized.