Nuedexta is indicated for pseudobulbar affect, but when the manufacturer attempted to expand its use into agitation in dementia they ran into some heavy legal penalties. Here we take a closer look at the published and unpublished trials to see what ─ if anything ─ is salvageable. We’ll also show you how to prescribe this high-cost drug as a generic equivalent.

Outdoor activity, massage, and touch therapy ranked most effective for agitation in dementia. Risperidone doesn’t appear to cause fractures.

Screening tests can also help distinguish normal aging from a Neurocognitive Disorder. The popular Mini Mental Status Exam is being replaced by more sensitive tests like the Montreal Cognitive Assessment (MOCA) and the Saint Louis University Mental Status Examination (SLUMS). Both of these can be completed in 10 minutes and are normed for Mild and Major Neurocognitive Disorders. An abbreviated form of the SLUMS, the Rapid Cognitive Screen, can be administered in 5 minutes.

Excessive alcohol use is neurotoxic, but some studies have found that moderate alcohol intake might actually reduce the risk of dementia. Most of these studies, however, have focused on geriatric patients.

The most common cause of parkinsonism is Parkinson disease, but parkinsonism also can occur from the use of any medication that blocks the D2 (dopamine type 2) receptor. Those include antipsychotics but can also include non-psychiatric medicines, particularly metoclopramide (Reglan), an anti-nausea medicine.