Which drug is listed for Lewy Body dementia treatment?

• A. Clozapine
• B. Haloperidol
• C. Risperidone
• D. Quetiapine

Answer: (D)

When managing psychosis in Lewy body dementia, choose an antipsychotic with the gentlest impact on motor symptoms. Haloperidol, a potent D2 blocker, reliably worsens parkinsonism and can trigger neuroleptic sensitivity in Lewy body disease, making it a poor choice. Risperidone similarly carries a higher risk of extrapyramidal symptoms, which can worsen motor function. Clozapine can be effective and has relatively low EPS risk, but it requires regular blood monitoring for agranulocytosis, which makes it less convenient and riskier in some settings. Quetiapine stands out because it has a lower propensity to cause extrapyramidal side effects and less aggravation of motor symptoms, making it the preferred option for treating psychosis or agitation in Lewy body dementia when an antipsychotic is needed. Use at a low dose and titrate slowly, with close monitoring for sedation, orthostatic effects, and overall tolerability.