rivastigmine-lewy body

[Yoyomama88]

I understand that ach-esterase inhibitors and antipsychotics are used to treat behavioral manifestations of lewy body dementia. Does this generally make the motor features of the disease worse?

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[neurodoc]

Don't know about the cholinesterase inhibitors, but patients with LB dementia do tend to be exquisitely sensitive
to the Parkinsonian side-effects of APD dopamine blockade, based on my clinical experience. In fact such sensitivity
can be taken as evidence in support of LB dementia.

 

[modisrules]

Antipsychotic treatment in DLB (and PD, for that matter) is generally limited to quetiapine and clozapine because they are so very limited in their dopamine receptor antagonism. Use of other atypicals (e.g. risperidone) will often quickly uncover or dramatically exacerbate parkinsonian symptoms, as has been stated above.