Psychosis in Alzheimer’s Disease

Clive Ballard, Helen C. Kales, Constantine Lyketsos, Dag Aarsland, Byron Creese, Roger Mills, Hilde Williams, Robert A. Sweet

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: To review the incidence, treatment and genetics of psychosis in people with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Recent Findings: Psychosis in Alzheimer’s disease (AD) has an incidence of ~ 10% per year. There is limited evidence regarding psychological interventions. Pharmacological management has focused on atypical antipsychotics, balancing modest benefits with evidence of long-term harms. The 5HT2A inverse agonist pimavanserin appears to confer benefit in PD psychosis with initial evidence of benefit in AD. Cholinesterase inhibitors give modest benefits in DLB psychosis. The utility of muscarinic agonists, lithium, glutamatergic and noradrenergic modulators needs further study. Summary: Recent work has confirmed the importance of psychosis in MCI as well as AD. The lack of evidence regarding psychological therapies is an urgent knowledge gap, but there is encouraging evidence for emerging pharmacological treatments. Genetics will provide an opportunity for precision medicine and new treatment targets.

Original languageEnglish (US)
Article number57
JournalCurrent neurology and neuroscience reports
Issue number12
StatePublished - Dec 1 2020


  • Alzheimer’s disease
  • Frequency
  • Impact
  • Mechanisms
  • Non-pharmacological
  • Pharmacological
  • Psychosis

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology


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