Effects of fluvoxamine on behavioral and psychological symptoms of dementia in Alzheimer's disease: a report of three cases.

Abstract

OBJECTIVE : To report 3 cases of severe behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD) with fluvoxamine treatment and to discuss the treatment implications for use of the drug. CASE SUMMARY: An 83-year-old woman was diagnosed with AD. Before treatment, she showed sudden irritation and excitement. Her BEHAVE-AD score was 40. She was started on fluvoxamine and quetiapine. Eight weeks later, she was friendly and thankful towards the staff. Her BEHAVE-AD score was 10. The second case was a 79-year-old woman diagnosed with AD. Before treatment, she attempted to leave our hospital and wandered and shouted throughout the day. Her BEHAVE-AD score was 42. She was started on fluvoxamine, and the dosage was gradually increased. Eight weeks later, the shouting and excitement disappeared almost completely. Her BEHAVE-AD score was 13. The third case was a 79-year-old man diagnosed with AD. Before treatment, we put him in a private, locked room because he was extremely agitated and violent because of delusions. His BEHAVE-AD score was 42. He was started on fluvoxamine and sodium valproate. Eight weeks later, the delusion became mild and did not affect his mood or behavior. His BEHAVE-AD score at this point was 4. DISCUSSION: Fluvoxamine was effective in controlling BPSD with AD. This finding shows that the pathophysiology of BPSD due to AD may occur because of a hyposerotonergic state in the brain. CONCLUSION: These cases show that fluvoxamine appears to be effective in the control of BPSD with AD.