Description
Once a decision has been taken to start anti-dementia therapy the drug should be titrated gradually, keeping en eye on cognitive, behavioural and functional changes. Reports from the patient or caregiver and the clinicians impression are important. Side-effects are commonly gastrointestinal and are usually transient. A decision whether or not to continue the drug is taken within two to four months of reaching the maximum tolerated dose. Once established, monitoring assessments should occur every three months. Termination is usually on the grounds of unacceptable side effects, apparent loss of effectiveness or non-compliance. A drug-free period of two to six weeks allows an assessment of whether or not there was benefit in cases of doubt. The skills necessary to administer these drugs effectively and fairly will increasingly become required of all clinicians looking after older people.
