Management of Lewy Body Dementia

Dementia

Use Rivastigmine

OR

Aricept

Motor problems

Carbidopa-Levodopa : Can worsen psychosis

Do not use Trihexyphenidyl (anticholinergics worsen confusion)

Depression

Use SSRI

Psychosis: For hallucinations and delusions use:

Clozapine (Avoid other antipsychotics such as Olanzapine)

OR

Pimavanserin (Nuplazid)

Antipsychotics are also dopamine antagonists and worsen parkinsonian symptoms

Parkinsonian meds are dopamine agonist and can worsen hallucinations.