Sundowner’s syndrome” is well recognized. Anxiety, delusional thinking, and sometimes aggressive behavior are usually triggered by patients’ misperceiving stimuli. Caregivers are trained to use techniques of distraction. Often, they do not work.

Drugs tested for treating psychiatric symptoms in Alzheimer’s include antidepressants for depression and irritability, antianxiety drugs (benzodiazepines) for anxiety and restlessness, and antipsychotic medications for hallucinations, delusions, agitation. These all have potential serious side effects and should be used with great caution.

A drug called Nuedexta, already approved to treat pseudobulbar affect, has been studied in treating agitation with Alzheimer’s, and results are promising.

Dr. Jack Florin, MD

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