As far as the effects on cognitive function (a secondary outcome measure in this study) were concerned, no changes were found in the MMSE score, as

observed in the control group. When BPSD accompanies severe AD, this frequently results in a considerable caregiving burden, appreciably complicates treatment and care, and leads to drug therapy with, for example, antipsychotic medications. Since elderly patients generally have reduced Inhibitors,research,lifescience,medical liver and kidney function and are thus more susceptible to adverse drug reactions, every effort must be made to reduce the dosing levels that are used in the elderly. In 2005, the US Food and Drug Administration (FDA) reported effects such as increased death rate caused by the use of new antipsychotic medications in elderly patients and also Inhibitors,research,lifescience,medical reported similar results with conventional antipsychotic medications. In elderly patients, IOX2 in vivo therefore, caution must be exercised when initiating drug therapy [Kudo, 2012]. The results of this study suggest that discontinuing donepezil treatment might not result in an increase in the risperidone equivalent Inhibitors,research,lifescience,medical dose, which would result

in at least a certain degree of improvement in safety. In particular, in elderly patients, benzodiazepine is known to impair cognitive function, and elderly patients being given benzodiazepine must be watched carefully for signs of delirium [Inoue et al. 2011]. The results of this study suggest that discontinuing donepezil treatment might help Inhibitors,research,lifescience,medical reduce the equivalent dose of diazepam, even if only a little, which results in cognitive impairment. Moreover, serotonin plays an important role in the emergence of behavioral symptoms in dementia [Lawlor, 1990]. Previous research has shown that trazodone is effective against agitation in patients presenting Inhibitors,research,lifescience,medical with BPSD [Pinner and Rich, 1988; Aisen et al. 1993; Lawlor et al. 1994; Sultzer et al. 1997]. Therefore, trazodone is sometimes used. Although discontinuing donepezil treatment increased the trazodone

dosage, the mean dose was 10.0 mg, suggesting that an appropriate level of safety was maintained. As defined by the International Psychogeriatric Association (IPA), BPSD are symptoms of dementia. Therefore, BPSD should be controlled using therapeutic medications for dementia, rather than off-label drugs. The findings of this study are consistent with this position. Limitations In Histone demethylase this study, the subjects had quite advanced (severe) dementia and, similarly, the different NPI subscale scores were very low, and we chose clinical assessments that could be investigated practically in a common clinical practice. Therefore, there were not many behavioral problems in the patients with AD with advanced stages of dementia and there was very little information about their clinical presentation.