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The goal of treatment is to control the symptoms of dementia. Treatment varies with the specific disorder. Hospitalization may be needed for a short time. The underlying causes should be identified and treated, this includes treating reversible organic lesions such as tumors.
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Stopping or changing medications that worsen confusion or that are not essential to the care of the person may improve cognitive function. Medications that contribute to confusion include anticholinergics, analgesics, cimetidine, central nervous system depressants, lidocaine, and others.
Disorders that contribute to confusion should also be treated. These include heart failure, decreased oxygen (hypoxia ), thyroid disorders, anemia, nutritional disorders, infections, and psychiatric conditions such as depression. Correction of co-existing medical and psychiatric disorders often greatly improves mental functioning.
Medications may be needed to control aggressive or agitated behaviors that are dangerous to the person with dementia or to others. These are usually given in very low doses and adjusted as necessary.
Possible medications for this use include the following:
- Anti-psychotics, given at night
- Serotonin-affecting drugs (trazodone, buspirone)
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Dopamine blockers (haloperidol, risperidal, olanzapine, clozapine)
- Cholinesterase inhibitors [donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne, formerly called Reminyl) for Alzheimer's-type dementia]
- Fluoxetine, imipramine, or Celexa to help stabilize mood
- Stimulant drugs (such as methylphenidate) to increase activity and spontaneity
- Vitamin E
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