Non-cognitive symptoms of dementia
People with dementia who develop non‑cognitive symptoms that cause them significant distress or who develop behaviour that challenges should be offered an assessment at an early opportunity to establish likely factors that may generate, aggravate or improve such behaviour.
Individually tailored care plans that help carers and staff address the behaviour that challenges should be developed, recorded in the notes and reviewed regularly.
KMPT GUIDELINES ON THE USE OF MEDICATION FOR THE MANAGEMENT OF BEHAVIOUR THAT CHALLENGES IN DEMENTIA
The assessment and effective treatment of pain is important
Even in people without overt pain a trial of paracetamol is worthwhile and has been shown to reduce agitation and overall neuropsychiatric symptoms
| Pack | Price |
|---|---|
| 100 ml | |
| 1000 ml | |
| 200 ml | £2.24 |
| 500 ml | |
| 80 ml |
| Pack | Price |
|---|---|
| 100 tablet | |
| 24 tablet | |
| 60 tablet |
| Pack | Price |
|---|---|
| 100 tablet | £1.59 |
| 1000 tablet | |
| 12 tablet | |
| 14 tablet | |
| 16 tablet | |
| 24 tablet | |
| 30 tablet | |
| 32 tablet | £0.51 |
| 48 tablet | |
| 50 tablet | |
| 5000 tablet | |
| 8 tablet | |
| 96 tablet |
Only licensed for 6 weeks treatment
Effect on psychosis or aggression is modest
Increases the risk of stroke
Review regularly and as a minimum at 4-6 weeks then 6 monthly
Dose: starting 0.25mg daily or BD; usual maintenance 0.5mg BD; maximum 1mg BD; optimal dose 0.5mg BD
| Pack | Price |
|---|---|
| 20 tablet | £0.59 |
| Pack | Price |
|---|---|
| 20 tablet | £0.61 |
| 6 tablet | |
| 60 tablet |
| Pack | Price |
|---|---|
| 60 tablet | £1.28 |
| Pack | Price |
|---|---|
| 20 tablet | |
| 60 tablet | £1.55 |
| Pack | Price |
|---|---|
| 20 tablet | |
| 60 tablet | £1.72 |
| Pack | Price |
|---|---|
| 28 tablet | £3.04 |
| 30 tablet | |
| 60 tablet |
| Pack | Price |
|---|---|
| 100 ml | £4.10 |
| Pack | Price |
|---|---|
| 28 tablet | £23.86 |
| Pack | Price |
|---|---|
| 28 tablet | £24.02 |
| Pack | Price |
|---|---|
| 28 tablet | £44.43 |
| Pack | Price |
|---|---|
| 28 tablet | £43.49 |
| Pack | Price |
|---|---|
| 28 tablet | £50.35 |
Only licensed for 6 weeks treatment
Effect on psychosis or aggression is modest
Increases the risk of stroke
Review and re-assess treatment regularly and as a minimum at 4-6 weeks then 6 monthly
For persistent aggression and psychotic symptoms in moderate to severe Alzheimer's dementia and vascular dementia (when non-pharmacological treatments ineffective and there is a risk of harm to self or others) the licensed dose is 0.5–5 mg daily in 1–2 divided doses, dose adjusted according to response at intervals of 1–3 days.
For the elderly the recommended dose is 500 micrograms daily, reassess after no more than 6 weeks.
Effect on psychosis or aggression is modest
Increases the risk of stroke
Review regularly and as a minimum at 4-6 weeks then 6 monthly
Dose: starting 2.5mg nocte; usual maintenance 2.5 - 10mg nocte; maximum 10mg nocte; optimal dose 5mg nocte
Plasma level reduced by up to 50% by cigarette smoke
Recommended dose initially 10ng adjusted as necessary to 5 - 20mg
Plasma concentration monitoring form ONLY for diagnosis of acute poisoning
| Pack | Price |
|---|---|
| 28 tablet | £6.91 |
| Pack | Price |
|---|---|
| 28 tablet | £15.00 |
| Pack | Price |
|---|---|
| 28 tablet | £12.10 |
| 56 tablet |
| Pack | Price |
|---|---|
| 28 tablet | £35.87 |
| 56 tablet |
| Pack | Price |
|---|---|
| 28 tablet | £26.35 |
| Pack | Price |
|---|---|
| 28 tablet | £46.50 |
| Pack | Price |
|---|---|
| 28 tablet | £20.18 |
| Pack | Price |
|---|---|
| 28 tablet | £34.83 |
| Pack | Price |
|---|---|
| 28 tablet | £34.81 |
| Pack | Price |
|---|---|
| 28 tablet | £49.74 |
| Pack | Price |
|---|---|
| 28 tablet | £37.24 |
| Pack | Price |
|---|---|
| 28 tablet | £66.76 |
| Pack | Price |
|---|---|
| 28 tablet | £58.01 |
| Pack | Price |
|---|---|
| 28 tablet | £96.14 |
Effect on psychosis or aggression is modest. Antipsychotic that is least likely to cause EPSE.
Increases the risk of stroke
Review regularly and as a minimum at 4-6 weeks then 6 monthly
Dose: starting 25mg BD; usual maintenance 100mg BD; maximum 400 BD
Cost effective use of quetiapine
Plasma concentration monitoring form ONLY for diagnosis of acute poisoning
| Pack | Price |
|---|---|
| 30 tablet | |
| 6 tablet | |
| 60 tablet | £13.84 |
| Pack | Price |
|---|---|
| 2 tablet | |
| 60 tablet | £52.22 |
| Pack | Price |
|---|---|
| 2 tablet | |
| 60 tablet | £61.75 |
| Pack | Price |
|---|---|
| 60 tablet | £51.30 |
| Pack | Price |
|---|---|
| 60 tablet | £73.45 |
| Pack | Price |
|---|---|
| 60 tablet | £67.66 |
| Pack | Price |
|---|---|
| 60 tablet | £113.10 |
| Pack | Price |
|---|---|
| 60 tablet | £113.10 |
| Pack | Price |
|---|---|
| 60 tablet | £170.00 |
| Pack | Price |
|---|---|
| 60 tablet | £226.20 |
Effect is modest at best
Only use for:
People with Lewy body dementia who have non-cognitive symptoms causing significant distress or leading to behavioral that challenges
People with mild, moderate or severe Alzheimer's disease who have non-cognitive symptoms and/or behaviour that challenges causing signficant distress or potential harm to the individual if a non-pharmacological approach is inappropriate or has been effective and antipsychotic drugs are inappropriate or have been ineffective
| Pack | Price |
|---|---|
| 28 tablet | £0.73 |
| Pack | Price |
|---|---|
| 28 tablet | £0.91 |
| 56 tablet |
| Pack | Price |
|---|---|
| 28 tablet | £7.09 |
| Pack | Price |
|---|---|
| 28 tablet | £8.41 |
| Pack | Price |
|---|---|
| 150 ml | £48.00 |
Effect is modest at best
Only use for:
People with Lewy body dementia who have non-cognitive symptoms causing significant distress or leading to behavioral that challenges
People with mild, moderate or severe Alzheimer's disease who have non-cognitive symptoms and/or behaviour that challenges causing signficant distress or potential harm to the individual if a non-pharmacological approach is inappropriate or has been effective and antipsychotic drugs are inappropriate or have been ineffective
| Pack | Price |
|---|---|
| 56 tablet | £61.13 |
| Pack | Price |
|---|---|
| 56 tablet | £74.10 |
| Pack | Price |
|---|---|
| 28 capsule | £51.88 |
| Pack | Price |
|---|---|
| 28 capsule | £64.90 |
| Pack | Price |
|---|---|
| 28 capsule | £79.80 |
| Pack | Price |
|---|---|
| 100 ml | £120.00 |
Effect is modest at best
Only use for:
People with Lewy body dementia who have non-cognitive symptoms causing significant distress or leading to behavioral that challenges
People with mild, moderate or severe Alzheimer's disease who have non-cognitive symptoms and/or behaviour that challenges causing signficant distress or potential harm to the individual if a non-pharmacological approach is inappropriate or has been effective and antipsychotic drugs are inappropriate or have been ineffective
| Pack | Price |
|---|---|
| 7 tablet |
| Pack | Price |
|---|---|
| 28 tablet | £32.78 |
| Pack | Price |
|---|---|
| 112 tablet | |
| 28 tablet | £1.18 |
| 56 tablet | |
| 7 tablet |
| Pack | Price |
|---|---|
| 100 gram | |
| 100 ml | |
| 50 gram | |
| 50 ml | £53.44 |
| Pack | Price |
|---|---|
| 7 tablet |
| Pack | Price |
|---|---|
| 28 tablet | £65.56 |
| Pack | Price |
|---|---|
| 28 tablet | £1.15 |
| 7 tablet |
Effect is modest at best
Only use for:
People with Lewy body dementia who have non-cognitive symptoms causing significant distress or leading to behavioral that challenges
People with mild, moderate or severe Alzheimer's disease who have non-cognitive symptoms and/or behaviour that challenges causing signficant distress or potential harm to the individual if a non-pharmacological approach is inappropriate or has been effective and antipsychotic drugs are inappropriate or have been ineffective
All patients prescribed a rivastigmine patch should be provided with the instructions for use and diary that has been provided by Novartis
| Pack | Price |
|---|---|
| 28 capsule | £1.96 |
| 56 capsule |
| Pack | Price |
|---|---|
| 28 capsule | £2.26 |
| 56 capsule |
| Pack | Price |
|---|---|
| 28 capsule | £23.52 |
| 56 capsule |
| Pack | Price |
|---|---|
| 28 capsule | £28.21 |
| 56 capsule |
| Pack | Price |
|---|---|
| 120 ml |
| Pack | Price |
|---|---|
| 120 ml | £96.82 |
| Pack | Price |
|---|---|
| 30 patch | £77.97 |
| Pack | Price |
|---|---|
| 30 patch | £30.02 |
| Pack | Price |
|---|---|
| 30 patch | £77.97 |