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Agitation is a common and clinically important neuropsychiatric symptom in Alzheimer's disease (AD), conferring risk of distress, caregiver burden, mortality and institutionalisation. Non-drug approaches are best practice for first-line treatment.1 In cases warranting pharmacological treatment, options are limited. Atypical antipsychotics are only justified in cases of severe symptoms due to their lack of efficacy and extensive side effects.2 ,3 Innovation in this field is therefore a high priority. Treatment with dextromethorphan and quinidine has been proposed due to their mechanistic antagonism of nicotinic α3β4 receptor and low-affinity N-methyl-D-aspartate …
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Funding NIHR, Maudsley Biomedical Research Unit for Dementia.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.