Successful treatment of behavioural problems in dementia using a cholinesterase inhibitor: the ethical questions.

Objective: To review the effect of cholinesterase inhibitors on the behavioural and neuropsychiatric symptoms of dementia and discuss the current clinical guidelines for the prescription of cholinesterase inhibitors in Australia.

Method: This paper reports the case of a patient with clinical diagnosis of dementia with lewy bodies (DLB) who was referred to an old age psychiatry service for the treatment of severe visual hallucinations and behavioural problems.

Results: Pharmacological treatment with olanzapine produced marked parkinsonism, agitation and confusion.