What is your antipsychotic of choice and general titration regimen in the outpatient setting for a patient with dementia and behavioral disturbances (assuming reversible causes such as urinary retention, constipation, etc. have been addressed)?

While not set in stone and knowing that there is a black box warning, make sure you get informed consent. I start with low doses of quetiapine (12.5 to 25 mg), as it has the shortest half-life, and will use it twice or 3 times a day. This allows for quicker recovery if they are too sedated. Depending on the response and time when behavior is at its peak, or if there is a known trigger, I will use a longer-acting atypical once or twice a day. Some atypical meds are more sedating, so dose them in ...

All have limited evidence, but aripiprazole, olanzapine, and risperidone generally have the most evidence behind them. (f.e, Maher et al., PMID 21954480). Caveat is brexpiprazole, which has FDA approval for use in Alzheimer's Dementia, in part because it was specifically studied for that purpose.

Selection can depend on dementia type and BPSD symptoms.

• For hyperactive symptoms with delusions, hallucinations, paranoia, etc., I find aripiprazole is well tolerated and not overly sedating. Also, limi...

For antipsychotics in BPSD - I have been following a similar version of this for years with good outcomes.

Chen et al., PMID 33340800