Management of Psychiatric Phenomena in Lewy Body Dementia

Lewy body dementia (LBD) encom-passes both dementia with Lewy bodies (DLB) and Parkinson’s disease with dementia (PDD). These forms of dementia are pathologically related by the findings of Lewy body neuronal inclusions. Patients with either disease are commonly faced with psychiatric symptoms such as psychosis, depres-sion, and anxiety. This review dis-cusses the similarities and differences between PDD and DLB with respect to the phenomenology, management, and impact of key psychiatric mani-festations. An important overarching theme is that most pharmacologic op-tions available to practitioners are of generally modest benefit and require important consideration for the poten-tial to worsen other symptoms. Thus, patients require careful monitoring and reassessment, as well as counseling on nonpharmacologic strategies and sup-port for caregiver burden.