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Role of Serotonin in the Behavioral and Psychological Symptoms of Dementia

Received July 28, 1999; revised March 23, 2000; accepted July 7, 2000. From the Division of Clinical Pharmacology and Department of Geriatric Psychiatry, Sunnybrook and Women's College Health Sciences Centre and Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada. Address correspondence to Dr. Lanctôt, Clinical Pharmacology and Psychiatry, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Room FG-20, Toronto, Ontario M4N 3M5 Canada. E-mail: krista.lanctot{at}swchsc.on.ca

The behavioral and psychological symptoms of dementia (BPSD) can have serious debilitating effects on the patient and increase caregiver burden. Investigations into the underlying neuropathology indicate that the serotonergic system may contribute to BPSD. In addition, serotonergic pathways are known to interact extensively with the cholinergic, noradrenergic, GABAergic, and dopaminergic systems. Hence, serotonergic therapies may be used to manipulate other neurotransmitters systems to alleviate BPSD or in combination with agents specific for the other neurotransmitter receptor sites. Neurotransmitter-modulated behaviors and evidence provided by pharmacological interventions are reviewed, focusing primarily on the serotonergic system.

Key Words: Dementia • Serotonin

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