Intranasal Oxytocin for Managing Agitation in a Patient of Mixed Dementia With Multiple Pathologies,Particularly With a History of Repetitive Head Injuries

Abstract

Background

Agitation is common in persons living with dementia (major neurocognitive disorder) and worsens with disease progression. Brexpiprazole is the sole FDA-approved drug for agitation in persons with Alzheimer’s dementia, but requires daily dosing over weeks. Limited pharmacologic options exist for acute agitation management.

Purpose

To show the efficacy of oxytocin for acute agitation management in dementia patients.

Case

We report a 70-year-old former professional wrestler with repetitive head trauma who developed dementia and severe agitation. He showed remarkable, rapid improvement with as-needed intranasal oxytocin 30 IU until his death. Post-mortem examination revealed mixed pathology: Alzheimer’s disease (Intermediate stage), Lewy Body disease (Limbic/Transitional stage), cerebrovascular disease with multiple infarcts, and chronic traumatic encephalopathy.

Conclusion

This case demonstrates the potential efficacy of intranasal oxytocin for acute agitation management in persons living with mixed dementia and may inspire further investigation.