Abstract
INTRODUCTION: Lewy body dementia (DLB) is a serious illness, affecting millions worldwide and currently the second most common etiology of the dementia spectrum. Patients, specifically the elderly, are devastated by the symptoms from this illness, chief of which are the disturbing visual hallucinations. Although medication exists to treat this disorder, the psychotropics generally prescribed have far-reaching implications for negative side effects and adverse events. This paper discusses the three medications quetiapine, rivastigmine, and donepezil and examines their risks-benefits profile in treating DLB. METHODS: Chiefly the PubMed database was consulted to gather relevant articles. One open-source database (OMICS) was used to cull several articles. All told, several dozen articles were reviewed, of which 13 were chosen for this review. RESULTS: The three medications reviewed, donepezil, rivastigmine, and quetiapine all have their place in DLB treatment; however, all have widely varying side effects, which are patient-specific. Of the three reviewed, donepezil proved to be the best tolerated at low dosages, and most effective at relieving visual hallucinations without EPS. CONCLUSION: Clinicians must be thoroughly conversant with as many psychotropics as possible, especially when treating DLB patients. Moreover, they must carefully weigh potential benefits against negative side effects. If they cannot make a strong case for use, then the best option is to forgo pharmacologic intervention.