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The authors describe the use of gabapentin in the treatment of 4 outpatients with dementia-associated agitation. On the basis of clinical case reports and the Overt Agitation Severity Scale, all 4 patients had reduced agitation with gabapentin. The results revealed that the risk of dementia associated with gabapentin or pregabalin exposure was significant in all subgroups except for the strata having depression or head injury. The risk of dementia development was higher in the younger group (age <50 years) than that in the older group. The authors describe the use of low-dose gabapentin to treat seven patients with a diagnosis of ICD-10 vascular or Mixed Vascular/Alzheimer Dementia with serious aggressive behavior. All seven patients had impressive and clinically significant responses to treatment. A small 2020 population-based study, however, found beta-blocker use was associated with an increased risk of vascular dementia, a type of dementia caused by changes in blood flow to the brain. Preliminary low-grade evidence based on case series and case reviews suggests possible benefit of gabapentin and pregabalin in patients with BPSD in Alzheimer's disease. These benefits cannot be confirmed until well-powered randomized controlled trials are undertaken. Gabapentin has been administered to several geriatric patients with bipolar disorder and patients with dementia. It has also been reported to be successful in the treatment of a 13-year-old boy with behavioural dyscontrol, a finding that suggested a possible role for gabapentin in the treatment of other behavioural disorders. dementia, who appeared to derive benefits in terms of symptom control and functioning from the introduction of gabapentin titrated up to 3600 mg day 1 alongside other interventions, is presented. RESULTS The evidence of gabapentin and dementia is mixed, with two studies looking at hundreds of thousands of people and coming to completely different conclusions. In 2011, Buskova et al. reported the use of gabapentin at a dose of 400 mg day −1 for dementia-associated nocturnal agitation in a 77-year-old woman with vascular dementia (VaD) with nocturnal episodes of confusion and multiple medical comorbidities 53; the patient was assessed using the Cohen–Mansfield Agitation Inventory (CMAI) with a dementia patient was only followed for three weeks. Next, it is unclear whether gabapentin is equally efficacious in Alzheimer’s dementia versus concomitant Alzheimer’s and vascular dementia. Additionally, the age difference of 17?years may have also contributed to the 97-year old’s limited response to gabapentin. Most of the data to guide gabapentin use and dosing in older adults is from pharmacokinetic studies or case reports[1,2] While gabapentin is approved to prevent seizures, most patients take gabapentin for reasons of neuropathic pain (71%) or psychiatric disorders, with bipolar being most common (15%), with an average dose of 975 mg per day We present the case of a patient with incipient vascular dementia accompanied by nocturnal agitation, which was successfully treated with gabapentin. Gabapentin appears to be useful and well-tolerated in this indication. Gabapentin has been given on a daily basis at a dose of 100 mg–3600 mg, mostly with favorable results in different types of dementia except for Lewy body dementia (LBD) [1], [6], [7], [11], [14]. It is effective in the majority of patients and well tolerated under 900 mg/d [11] , [14] . (See "Treatment of Alzheimer disease" and "Frontotemporal dementia: Treatment" and "Prognosis and treatment of dementia with Lewy bodies" and "Treatment of vascular cognitive impairment and dementia" and "Management of the patient with dementia" and "Care of patients with advanced dementia".) SYMPTOM ASSESSMENT Some studies suggest gabapentin is effective and well-tolerated for treating behavioral symptoms in dementia patients, while other studies indicate it may increase the risk of dementia and cognitive decline. Our findings suggest that gabapentin should be considered for treating aggressive behavior in patients with vascular or mixed dementia and that it is well tolerated in this context. B ehavioral and psychological symptoms of dementia (BPSD) are common symptom manifestations in dementia. Recent reports highlighting serious adverse effects of antipsychotic medication in behavioral and psychological symptoms of dementia (BPSD) has led to calls for research on alternative agents. The authors describe the use of low-dose gabapentin to treat seven patients with a diagnosis of ICD-10 vascular or Mixed Vascular/Alzheimer Dementia with serious aggressive behavior. All seven patients Recent reports highlighting serious adverse effects of antipsychotic medication in behavioral and psychological symptoms of dementia (BPSD) has led to calls for research on alternative agents. The authors describe the use of low-dose gabapentin to treat seven patients with a diagnosis of ICD-10 vascular or Mixed Vascular/Alzheimer Dementia with serious aggressive behavior. All seven patients We would like to show you a description here but the site won’t allow us. Gabapentin has been increasingly prescribed to older adults for off-label indications, and accumulating evidence suggests potential for gabapentin misuse and related adverse events. However, the relation between gabapentin initiation and longer-term neurocognitive changes is not well understood.
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