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.

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

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

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

Increases the risk of stroke

Review regularly and as a minimum at 4-6 weeks then 6 monthly

Dose: starting 10mg mane; usual maintenance 15mg mane; maximum 30mg mane

 

Plasma concentration monitoring form ONLY for diagnosis of acute poisoning

Pack Price
28 tablet £1.12
Pack Price
28 tablet £1.18
Pack Price
28 tablet £1.29
Pack Price
28 tablet £11.09
Pack Price
28 tablet £78.06
Pack Price
28 tablet £78.06
Pack Price
150 ml £100.72

0.5mg up to four times a day

Can be used short term for up to 4 weeks

Beyond 4 weeks has been shown to be associated with a greater risk of tachyphylaxis, tolerance and falls 

Pack Price
100 tablet
1000 tablet
28 tablet £3.74
30 tablet
50 tablet
Pack Price
28 tablet £8.82
30 tablet

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 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

Patient instructions for use and diary

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