Psychosis Associated with Dementia: Evaluation and Management: ECT Mentioned

 Out on Pubmed, form authors in the USA, is this review:

Psychosis associated with dementia: evaluation and management.

Tampi RR, Joshi P, Jeste DV.Schizophr Res. 2025 May 3;281:82-90. doi: 10.1016/j.schres.2025.04.022. Online ahead of print.PMID: 40319614 Review

The abstract is copied below:

Dementia is one of the most common neurodegenerative disorders in the world, and 34-63 % of individuals with dementia have psychotic symptoms. Neurobiological correlates of dementia with psychosis include significantly increased densities of senile plaques and neurofibrillary tangles and higher D3 receptor density. Limitations of proposed diagnostic criteria include a lack of specificity for psychotic symptoms in individuals with dementia, a lack of consistent differentiation between symptoms, late recognition, and not accounting for comorbid depression or agitation that may be the primary symptom, which makes diagnosis challenging. This review aims to provide clinicians, researchers, and policymakers with a comprehensive evaluation of psychosis in dementia, covering its epidemiology, neurobiology, diagnosis, and treatment strategies. We review both psychosocial and pharmacological interventions for dementia-related psychosis. Psychosocial treatments such as meaningful communication between persons with dementia and their caregivers, simplifying the living environment, and optimizing tasks can help reduce the adverse impact of psychosis. Evidence from meta-analyses indicates modest efficacy for cholinesterase inhibitors, antidepressants, and antipsychotics for psychosis in dementia. The use of antipsychotic medications is limited by increased risks for serious adverse effects including cerebrovascular events and death. Emerging therapies such as xanomeline-trospium present promising avenues for treatment. By synthesizing current evidence and clinical guidelines, this review provides a framework for improving diagnosis and treatment of psychosis in dementia, helping clinicians and researchers refine patient care strategies while informing future research directions.

Keywords: Antipsychotics; Cholinesterase inhibitors (ChEIs); Electroconvulsive therapy (ECT); Neuropsychiatric symptoms; Repetitive transcranial magnetic (rTMS).

The review is here.

And from the text:

The use of ECT to treat either psychosis or agitation in dementia is likely to become even more important in the future. While ECT did not make it into the abstract here, it is included in the "keywords" and the treatment algorithm.