Do we overtreat dementia?
John M. S. Pearce
The most frequent and devastating accompaniment of aging is dementia. Most manoeuvres aimed to improve the relentless decline in quality of the dement’s life are based on relief of symptoms rather than an attack on causal mechanisms. Drugs for dementia provide only small measurable benefits for many patients. We should avoid the common clinical practice of overtreatment: prescribing one drug after another, or several drugs at the same time and numerous, often unsuccessful attempts to impede the dementing process.
If there is poor response or if side effects outweigh benefits, doctors should seriously consider the advantages of monitored withdrawal. These are not grounds for therapeutic nihilism because future treatments may halt or reverse the causal neurodegeneration.
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