Dementia with Lewy bodies (DLB)
- Cholinesterase inhibitor often improves cognition/behavior
- Levodopa can help parkinsonism but may worsen psychosis
- Avoid potent D2 blockers when possible
- Quetiapine/clozapine used cautiously for severe psychosis
- Treat REM-sleep behavior and autonomic symptoms separately
- Marked antipsychotic sensitivity is a key hazard
Use at a glance
- Cholinesterase inhibitor often improves cognition/behavior
Treatment options
- Levodopa can help parkinsonism but may worsen psychosis
- Treat REM-sleep behavior and autonomic symptoms separately
- Marked antipsychotic sensitivity is a key hazard
Practical pearls
- Quetiapine/clozapine used cautiously for severe psychosis
Safety / pitfalls
- Avoid potent D2 blockers when possible
Self-check
- What hazard limits antipsychotics in DLB?
Marked antipsychotic sensitivity. - Which blockers are avoided when possible in DLB?
Potent D2 blockers when possible.
Drugs used for this (2)
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