Changing Clinical Care for Neuropsychiatric Symptoms of Dementia: Jacob Mintzer, MD, MBA

“The fact that there are limitations to what we can do from a behavioral [intervention] point of view is clear when you look at the amount of prescriptions that are off-label, of medications that are not indicated [for this], that we know have side effects that are undesirable, that are prescribed every day. I resist the belief that these doctors want to hurt their patients or that their family is resistant or against doing any behavioral interventions.”

Individuals with dementia and their families experience a number of challenges that accompany the neurodegenerative disease, particularly concerning the come-and-go nature of some symptoms. There have been few pharmacologic approaches for symptoms such as psychosis and agitation, and the off-label options can carry quite a few unwanted adverse events.

Although in recent years the push to finally get an approved and effective disease-modifying therapy has never been more top of mind, the neuropsychiatric symptoms many patients deal with on a day-to-day basis are still a cause for concern. For Jacob Mintzer, MD, MBA, professor of health science, Medical University of South Carolina, this is an extraordinarily important issue to address for these patients, who are elderly and often highly comorbid.

Mintzer sat down with NeurologyLive to discuss this need, as well as to share his insight into the current approaches for these patients. Many of these interventions are behaviorally based and require both tact and buy-in from the patient to achieve. He offered his experience with these behavioral approaches and the general treatment of these complex neuropsychiatric symptoms. “When we are left with a fair amount of patients who are suffering. we need tools,” he said.