Table 1.

Comparison of each neuropsychiatric symptom of patients with AD and general patients.

NPS	Category	General Patients	Patients with AD
Depression	Prevalence	5–8.3%	14.8–40%
	Symptoms	Feeling sad, irritable, empty, disrupted sleep, hopelessness about the future, poor concentration, weight change, low energy, excessive guilt, or low self-worth	Persistent feelings of worthlessness, excessive/inappropriate guilt, a pervasive loss of interest or pleasure in all activities
	Treatment	SSRIs (citalopram, fluoxetine, paroxetine, sertraline), SNRIs (duloxetine, vanlafaxine, levomilnacipran), Atypical antidepressants (bupropion, mirtazapine, trazodone, vortioxetine), TCAs (imipramine, desipramine, amitriptyline), MAOIs (selegiline)	SSRIs (fluoxetine, paroxetine, sertraline, citalopram, escitalopram)
	Side effects	Nausea and vomiting, agitation, anxiety, indigestion, diarrhea or constipation, loss of appetite and weight loss, dizziness, blurred vision, dry mouth, excessive sweating, insomnia or drowsiness, headaches, and sexual side effects	No significant effects
Anxiety	Prevalence	4%	39%
	Symptoms	Trouble concentrating or making decisions, feeling irritable, tense or restless, nausea or abdominal distress, heart palpitations, sweating, trembling or shaking, and sleep problem	Excessive worry, fear, restlessness, and irritability
	Treatment	Benzodiazepines (alprazolam, diazepam, lorazepam), SSRIs, buspirone, TCAs (imipramine, clomipramine), MAOIs	SSRIs, SNRIs (venlafaxine), serotonergic atypical anxiolytics (buspirone), citalopram
	Side effects	Problems with balance and memory, drowsiness, confusion, vision problems, headaches, feelings of depression, dizziness, nausea, constipation, urinary retention, constipation	Abnormal bleeding, seizures, headaches, nausea, sleep trouble
Apathy	Prevalence	26–82%	49%
	Symptoms	Feeling flat, blunt, or numb emotionally, lack of emotional reaction, low energy and motivation, lack of goal setting, less interest in pleasure activities, hobbies, and relationships, anhedonia, lethargy	A decline in motivation and interest across emotional, goal-directed behavior, and cognitive activity
	Treatment	Antidepressants (trazodone, deprenyl, fluvoxamine), psychostimulants (methylphenidate, amphetamine), antipsychotics (risperidone), acetylcholinesterase inhibitors (donepezil, rivastigmine), NMDA receptor antagonists (memantine)	Cholinesterase inhibitors (donepezil, galantamine, rivastigmine), methylphenidate, Ginkgo biloba, modafinil, and SSRIs
	Side effects	Modest weight loss, no change in depression score	Weight loss and increased anxiety, no improvement, high blood pressure, cough, and osteoarticular pain
Agitation and Aggression	Prevalence	1–30%	30–60%
	Symptoms	Road rage, child abuse, sexual abuse, and domestic violence, verbal (swearing, shouting, or threatening), physical (hitting, punching, scratching, or biting)	Emotional distress, excessive psychomotor activity, aggressive behaviors, disruptive irritability, and disinhibition
	Treatment	Haloperidol, aripiprazole, droperidol, olanzapine,	Valproic acid, brexpiprazole, carbamazepine, SSRIs
	Side effects	Dizziness and nausea, paradoxical excitation, constipation, dry mouth, problems sleeping	Hepatotoxicity, GI upset, thrombocytopenia, coagulopathies, metabolic disorders, worsening cognitive dysfunction, agranulocytosis, cardiac arrhythmias
Psychosis	Prevalence	1.5–3.5%	50%
	Symptoms	Delusions, hallucinations, disorganized thought and behavior, poverty of speech, lack of energy, anhedonia, psychomotor retardation, catatonia	Delusions, hallucinations, disorganized thought and speech
	Treatment	Antipsychotics (clozapine and olanzapine), Benzodiazepines	Aripiprazole, risperidone, quetiapine, brexpiprazole
	Side effects	Drowsiness, dizziness, dry mouth, blurred vision, tiredness, nausea, constipation, weight gain, trouble sleeping, or muscle or nervous system problems (anxiety, agitation, jitteriness, drooling, trouble swallowing, restlessness, shaking, or stiffness)	Stroke, myocardial infarction
Sleep disturbances	Prevalence	20–41.7%	45%
	Symptoms	Excessive daytime sleepiness, irregular breathing or increased movement during sleep, depression, weight gain, lack of concentration, daytime fatigue, irritability, anxiety	Insomnia, excessive daytime sleepiness, nighttime awakenings, and alterations in sleep–wake patterns
	Treatment	Melatonin, zolpidem, zaleplon, eszopiclone, ramelteon, suvorexant, lamborexant or doxepin	Melatonin, trazodone, suvorexant, lemborexant
	Side effects	Changes in appetite, constipation or diarrhea, dizziness, headache, daytime drowsiness, heartburn, stomach pain, burning or tingling in the hands, arms, feet or legs, mental impairment	Various results, unclear effects
Social processing	Prevalence	7–11%	30–50%,
	Symptoms	Difficulty using appropriate greetings, changing language and communication style, telling and understanding stories, engaging in conversation, repairing communication breakdowns, using appropriated verbal and nonverbal signals, interpreting the verbal and nonverbal signals of others, making inferences, and forming and maintaining close relationships	Language problems, personality changes, and irritability
	Treatment	Behavior interventions, social communication treatments (comic strip conversations), social communication intervention, online speech therapy, social skills strengthening activities	N-acetyl cysteine, BDNF, NGF