Davangere Devanand, MBBS, MD: Challenges in Symptom Management in Alzheimer Disease

"When it comes to treatment of agitation, or, for that matter psychosis, in Alzheimer's, one of the first things which is often not done is behavioral management in dealing with a patient."

Davangere P. Devanand, MBBS, MD, sat with NeurologyLive at the Alzheimer’s Association International Conference held in Chicago, Illinois, to discuss the possibility of neurologists and psychiatrists prescribing lithium at low doses for patients with Alzheimer and symptoms of agitation. While toxic in high doses, the therapy has begun to show possible efficacy in pilot programs and is currently undergoing phase II testing.

The professor of psychiatry in neurology at the Gertrude H. Sergievsky Center at Columbia University Medical Center spoke about the importance of this phase II trial, and how there are many issues that come up in treating the psychiatric symptoms of Alzheimer disease. Many of these issues, he noted, can stem from a lack of understanding and education of the caregivers of these patients.

Devanand also noted the difficulty findings biomarkers in this condition, due to the problems with acquiring the proper data from these patients—mainly due to struggles with them cooperating over long stretches of time for amyloid PET scans and exams. Currently, the only biomarker options that are easily accessible to physicians are those found in the blood, though none have been identified in Alzheimer.