Which antipsychotic is licensed to manage non-cognitive dementia symptoms?

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

Answer: (A)

Focusing on licensing for behavior in dementia helps differentiate how these drugs are intended to be used. Haloperidol is the antipsychotic that has a licensed indication in many regions for the short-term management of agitation and aggression in dementia. Because it carries a clear, approved use for this non-cognitive symptom, it stands out as the best choice when a licensed option is required.

It’s important to balance this with safety: elderly patients with dementia are particularly vulnerable to side effects such as extrapyramidal symptoms, slowed movement, sedation, and heart rhythm changes (QT prolongation). These risks mean haloperidol should be used at the lowest effective dose and for the shortest possible duration, with careful monitoring and regular reassessment.

The other antipsychotics listed do not carry a specific licensed indication for dementia-related behavioral symptoms in most guidelines. They may be used off-label or for other conditions, but they lack the formal licensing for this particular use (and clozapine is reserved for treatment-resistant schizophrenia).