Possible adverse effects include skin allergies, phototoxic reactions, and potentiation of sedative-hypnotic medications when used with lavender or other oils known to have sedating effects. Pregnant women should exercise caution when considering aromatherapy because of possible effects on the fetus and uterus caused by systemic absorption of certain essential oils.
The application of weak electric current to the head or neck may temporarily improve memory, behavior, and activities of daily living in patients with dementia.26,27 A Cochrane meta-analysis of 3 studies of transcranial electrical nerve stimulation devices used to treat dementia found evidence of significant but transient improvements in word recall, face recognition, and motivation immediately following treatment.28 Most research findings show that improvements are not sustained 6 weeks or more after treatment is terminated.
Music is used in many healing traditions to calm the mind and reduce agitated behavior. Findings of a meta-analysis evaluating studies of music therapy in persons with dementia show that various approaches--singing, dance, listening to music, and musical games--are associated with improvements in cognitive and behavioral functioning in persons with severe dementia, including reduced agitation, reduced wandering, enhanced social interaction, improved mood, reduced irritability and anxiety, increased cooperative behavior, and improved performance on standardized scales including the Mini-Mental State Examination.29
Regular music therapy was shown to reduce irritability and to improve expressive language in persons with dementia.30 Listening to binaural sounds in the beta frequency range (16 to 24 Hz) using headphones may enhance performance on tests of attention and short-term and immediate recall in healthy volunteers.31
Open studies, case reports, and one double-blind trial suggest that Healing Touch (HT) and Therapeutic Touch (TT) have beneficial effects on agitation in patients with dementia. In one small open study, measures of agitation were significantly improved in 14 residential patients with dementia who received 3 HT treatments weekly over a 4-week period.32 Diminished need for psychotropic medications was observed in 3 patients during the active treatment phase, and 2 residents required dose increases in the first 2 weeks after HT treatments were stopped.
In another small, sham-controlled study, 3 weekly 10- to 20-minute HT treatments were administered to patients with AD over a 5-week period. Patients who received regular HT treatments were found to have consistent reductions in disruptive behaviors and globally improved emotional and cognitive functioning, including enhanced socialization, a more regular sleep schedule, improved compliance with nursing home routines, greater emotional stability, and improved communication with staff. In a double-blind study (N = 57) that included mock TT in the control arm, agitated patients with dementia who received 2 brief TT treatments daily for 3 days exhibited significantly fewer behavioral symptoms of dementia, including reduced restlessness and fewer disruptive vocalizations, than patients who received mock TT.33
Dr Lake is in private practice in Monterey, Calif, and is an adjunct clinical instructor in the department of psychiatry and behavioral sciences at Stanford University in Stanford, Calif. He co-chairs the American Psychiatric Association Caucus on Complementary, Alternative, and Integrative Medicine (www.APACAM.org) and is author of the soon-to-be-published Textbook of Integrative Medical Health Care (Thieme).
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