IIf there is an acute cause of a behavioral symptom in dementia, doctors do not jump in and treat the person with psychotropic medications. Instead, they try to use non-psychopharmacological approaches to treat the cause itself.
Once those causes have all been taken care of, or if none have been identified, doctors will still try to avoid treatment with psychotropic medications by trying to modify the environment that the person is living in. For example, is there a way to either avoid or fix the stressor that’s causing a particular behavior in order to make it better? If somebody is wandering, can something be changed to prevent it? If a task is too complex, can it be made simpler? In advanced dementia, if somebody has trouble eating, can assistance be given? Doctors will try to keep the person’s activities appropriate for the level of dementia that exists.
Later on, things might need to be done for people who can no longer do certain tasks. It is, however, important to keep realistic expectations both for the person and the caregivers in terms of non-medication approaches to treating behavioral symptoms.
Eventually, the doctor may turn to medications for specific target symptoms. If a symptom looks like depression or anxiety, an antidepressant might be prescribed. If the person is suffering from something like hostility, suspiciousness, paranoia or things that are out of touch with reality (which basically define psychosis), the doctor may try antipsychotics.
However, it's important to bear in mind that no medications are actually approved by the U.S. Food and Drug Administration (FDA) for behavioral disturbance and dementia. The help of behavioral experts, combined with that of doctors or specialists, will determine whether or not it's right to use a particular medication.