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Pharmacological strategies for managing dementia with Lewy bodies: an expert review of symptom-targeted care

Lookup NU author(s): Professor John-Paul TaylorORCiD, Dr Judith HarrisonORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).

Abstract

© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Introduction: Dementia with Lewy Bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer’s disease, characterized by a complex combination of cognitive, neuropsychiatric, motor, autonomic, and sleep-related symptoms. Symptom fluctuation, polypharmacy risks, and high sensitivity to commonly used drugs present unique challenges for management. Areas covered: This review provides a comprehensive overview of the symptomatic management of DLB, organized by clinical domains. It critically evaluates current pharmacological and non-pharmacological treatment strategies for cognitive impairment, hallucinations, parkinsonism, autonomic dysfunction, and sleep disturbances. Evidence is drawn from clinical trials, meta-analyses, and extrapolated findings from related disorders such as Alzheimer’s disease and Parkinson’s disease. Expert opinion: Effective DLB management requires an individualized, symptom-prioritized approach that carefully balances therapeutic benefit with potential adverse effects, particularly given the high risk of antipsychotic sensitivity and treatment-induced worsening of symptoms. Despite recent progress, evidence remains sparse for many symptom domains. Greater investment in DLB-specific clinical trials and development of targeted therapies is urgently needed to improve patient outcomes.

Publication metadata

Author(s): Atewogboye O, Taylor JP, Harrison JR

Publication type: Review

Publication status: Published

Journal: Expert Review of Clinical Pharmacology

Year: 2025

Volume: 18

Issue: 9

Pages: 645-653

Online publication date: 16/09/2025

Acceptance date: 11/09/2025

ISSN (print): 1751-2433

ISSN (electronic): 1751-2441

Publisher: Taylor and Francis Ltd.

URL: https://doi.org/10.1080/17512433.2025.2562151

DOI: 10.1080/17512433.2025.2562151

PubMed id: 40955908

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