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Am Fam Physician. 2004;70(3):447-448

to the editor: I enjoyed the article1 on the use of antipsychotic medications in the elderly by Motsinger and colleagues and found the content to be very helpful. However, the authors failed to differentiate the types of dementia and to mention a rather common, and often underdiagnosed, form of dementia—Lewy bodies dementia. This disorder is heralded by cognitive decline, Parkinson-type behaviors, and behavioral issues, including psychosis. Often, antipsychotic medication would seem appropriate and useful for these patients. However, with this form of dementia, antipsychotics, including atypical antipsychotic drugs, can exacerbate the problem and lead to iatrogenic complications. Therefore, a family physician who is presented with a patient who has dementia and behavioral issues should be careful with the diagnosis and type of dementia. These physicians should be aware that not all dementias are alike and not all are Alzheimer's disease.

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