The role of norepinephrine in the behavioral and psychological symptoms of dementia

J Neuropsychiatry Clin Neurosci. Summer 2004;16(3):261-76. doi: 10.1176/jnp.16.3.261.


The behavioral and psychological symptoms of dementia (BPSD) are common serious problems that are a major contributor to caregiver burden. Despite their significance, the underlying neurobiology of these disturbances is still unclear. This review examines the role of norepinephrine (NE) on BPSD, including depression, aggression, agitation and psychosis. A number of lines of evidence suggest that NE dysfunction leading to BPSD may result from increased NE activity and/or hypersensitive adrenoreceptors compensating for loss of NE neurons with progression of Alzheimer's disease (AD). With greater appreciation of the underlying neurobiology of behavioral and psychological symptoms of dementia (BPSD) more effective, rational, targeted pharmacotherapy will hopefully emerge.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antipsychotic Agents / therapeutic use
  • Behavioral Symptoms / classification
  • Behavioral Symptoms / drug therapy
  • Behavioral Symptoms / etiology*
  • Behavioral Symptoms / metabolism*
  • Dementia* / complications
  • Dementia* / metabolism
  • Dementia* / psychology
  • Dopamine beta-Hydroxylase
  • Humans
  • Mental Disorders / drug therapy
  • Mental Disorders / etiology*
  • Mental Disorders / metabolism*
  • Norepinephrine / physiology*


  • Antipsychotic Agents
  • Dopamine beta-Hydroxylase
  • Norepinephrine