Journal
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
Volume 20, Issue 12, Pages -Publisher
SPRINGER
DOI: 10.1007/s11910-020-01074-y
Keywords
Alzheimer's disease; Psychosis; Frequency; Impact; Mechanisms; Non-pharmacological; Pharmacological
Categories
Funding
- Biomedical Research Unit for Dementia
- Maudsley Biomedical Research Centre (BRC)-dementia theme at the King's College London, London, UK
- Acadia pharmaceutical company
- Lundbeck
- Roche
- Otsuka
- Eli Lilly
- Johns Hopkins ADRC [P50AG005146]
- Astra-Zeneca
- Novartis Pharmaceuticals
- GE Health
- Heptares
- Royal Society Wolfson Research Merit Award
- Wolfson Foundation
- Royal Society - National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust andKing's College London
- Acadia Pharmaceuticals
- Addex Therapeutics
- Addex Pharmaceuticals
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Purpose of Review To review the incidence, treatment and genetics of psychosis in people with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Recent Findings Psychosis in Alzheimer's disease (AD) has an incidence of similar to 10% per year. There is limited evidence regarding psychological interventions. Pharmacological management has focused on atypical antipsychotics, balancing modest benefits with evidence of long-term harms. The 5HT2A inverse agonist pimavanserin appears to confer benefit in PD psychosis with initial evidence of benefit in AD. Cholinesterase inhibitors give modest benefits in DLB psychosis. The utility of muscarinic agonists, lithium, glutamatergic and noradrenergic modulators needs further study. Summary Recent work has confirmed the importance of psychosis in MCI as well as AD. The lack of evidence regarding psychological therapies is an urgent knowledge gap, but there is encouraging evidence for emerging pharmacological treatments. Genetics will provide an opportunity for precision medicine and new treatment targets.
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