We previously reported that aging process and disease progression of Alzheimer’s disease (AD) connected depressive symptoms (affective disturbance and anxiety) with psychotic symptoms such as delusion, hallucination and aggressiveness. These features are mixed state of manic state and depressive state, therefore, there might be relationship between bipolarity (BT) and psychological symptoms of dementia (BPSD) in AD. From these reports, we considered that BPSD in AD should be treated as “augmentation” (pharmacotherapy for bipolar disorder) .
In this previous article, we proposed the reasonability of prescribing the atypical antipsychotics for BPSD in AD. However, in Japan, there are currently no licensed medicines for the management of BPSD in AD patients although in case of oldest old patient antidepressant is useful for ameliorating BPSD in AD.