Main Cause of Dementia - Depression
Robert Baird
October 31, 2007
If a potentially reversible form of dementia is found, then the treatment logically follows. For example, if a brain tumor is discovered, then surgery, radiation therapy, or chemotherapy would be prescribed. Similarly appropriate therapy would follow for the various endocrine (glandular), metabolic, or toxic disorders.
Whereas only one out of five patients is found to have a specific underlying cause for which treatment is available, the physician is frequently limited to providing therapy to treat the symptoms. Certain symptoms of dementia may respond to medicine or behavioral therapy. Depression frequently accompanies dementia, especially in the early stages. Depression can by itself give rise to a dementia syndrome and may respond favorably if treated. An antidepressant medication is typically prescribed. Various antidepressants act as sedatives while others serve to stimulate. A medication best suited to the patient's needs will be chosen.
Another symptom that may arise, especially in the late phases of dementia, is sundowning: a person will become confused late in the day, i.e., when the sun goes down. The individual may become agitated and violent as well. A small dose of a tranquilizer will usually suffice to control the situation if behavioral intervention does not prove successful. The most widely used tranquilizers for dementia are thioridazine (Mellaril), chlorpromazine (Thorazine), haloperidol (Haldol), thiothixine (Navane), and c10zapine (Clozaril). All of these agents have potential side effects, one of the most bothersome and potentially dangerous of which is the occurrence of a Parkinsonian-like state. The increase in muscle tone, tremor, and poor balance can give rise to functional disability. Of the major tranquilizers, clozapine (Clozaril) has the least tendency to give rise to Parkinsonian symptoms; however, it does pose a significant risk for the development of agranulocytosis, a dangerous drop in the white blood cell count. Careful monitoring of the white cell count is required during treatment with clozapine (Clozaril). Sudden drops in blood pressure with resultant fainting can occur with thioridazine (Mellaril) and chlorpromazine (Thorazine).
It should be emphasized that most behavioral outbursts can be handled without medication. Routine dosages of the major tranquilizers are usually not required and should not be employed in lieu of nurses or therapists. A variety of medications have been marketed as dilators (expanders) of brain arteries. Such agents are papaverine and cyclandelate. These agents were originally marketed when it was believed that the usual forms of dementia were caused by "hardening of the arteries." It is now known that the principal form of dementia, Alzheimer's disease, has no more arteriosclerosis than would be expected based on age. The vasodilators therefore have a poor rationale and are now used infrequently.
Another category of medication is that of the metabolic enhancers, the best-known agent being a combination of ergoloid mesylates(Hydergine). This agent, while not impressive in its results, does have a substantial body of literature to suggest that it may be of mild benefit for some of the symptoms of dementia. A trial of this agent usually extends over several months to determine whether it may be of benefit. A realistic assessment of the value of such medications focuses on whether or not they slow the expected rate of decline. Some believe that the ergoloid mesylates may favorably alter the rate of disease progression.
Lecithin or choline have been used in the attempt to increase the brain chemical acetylcholine, which is known to be reduced in Alzheimer's disease. Lecithin and choline are building blocks in the formation of acetylholine. Tacrine hydrochloride (Cognex) acts to reduce the breakdown of acetylcholine. Initial study reports purported to show impressive gains in cognitive performance and everyday activities of daily living with the use of tacrine (Cognex). Unfortunately, results from large-scale clinical trials were not as impressive. Tacrine (Cognex) may be beneficial to some patients with mild to moderate disease; however, the drug does not stop be progression of the disease and any benefit derived can be expected to deteriorate with time. Realistically, the most that should be expected is a slowing in the progress of the disease by a few months in some patients. Tacrine (Cognex) is approved by the U.S. Food and Drug Administration for the treatment of Alzheimer's disease.
Recently, the Pharmaceutical Research and Manufacturers of America listed sixteen drugs in development for Alzheimer's disease . Eight of these agents were in phase III clinical trials, that is, tests of the effectiveness of the drug in large numbers of patients with Alzheimer's disease.
Get started with latest information about < a href = "http://www.alzheimersadvice.org/" >alzheimer's disease and various disorders like < a href = "http://www.alzheimersadvice.org/deficits-of-alzheimers-disease/communication-or-language-problem" > communication problems , language problems. If you like the above article and you want to publish it in your site or ezine, you may freely do so, you just need to provide a link back to authors site at http://www.alzheimersadvice.org/.
Whereas only one out of five patients is found to have a specific underlying cause for which treatment is available, the physician is frequently limited to providing therapy to treat the symptoms. Certain symptoms of dementia may respond to medicine or behavioral therapy. Depression frequently accompanies dementia, especially in the early stages. Depression can by itself give rise to a dementia syndrome and may respond favorably if treated. An antidepressant medication is typically prescribed. Various antidepressants act as sedatives while others serve to stimulate. A medication best suited to the patient's needs will be chosen.
Another symptom that may arise, especially in the late phases of dementia, is sundowning: a person will become confused late in the day, i.e., when the sun goes down. The individual may become agitated and violent as well. A small dose of a tranquilizer will usually suffice to control the situation if behavioral intervention does not prove successful. The most widely used tranquilizers for dementia are thioridazine (Mellaril), chlorpromazine (Thorazine), haloperidol (Haldol), thiothixine (Navane), and c10zapine (Clozaril). All of these agents have potential side effects, one of the most bothersome and potentially dangerous of which is the occurrence of a Parkinsonian-like state. The increase in muscle tone, tremor, and poor balance can give rise to functional disability. Of the major tranquilizers, clozapine (Clozaril) has the least tendency to give rise to Parkinsonian symptoms; however, it does pose a significant risk for the development of agranulocytosis, a dangerous drop in the white blood cell count. Careful monitoring of the white cell count is required during treatment with clozapine (Clozaril). Sudden drops in blood pressure with resultant fainting can occur with thioridazine (Mellaril) and chlorpromazine (Thorazine).
It should be emphasized that most behavioral outbursts can be handled without medication. Routine dosages of the major tranquilizers are usually not required and should not be employed in lieu of nurses or therapists. A variety of medications have been marketed as dilators (expanders) of brain arteries. Such agents are papaverine and cyclandelate. These agents were originally marketed when it was believed that the usual forms of dementia were caused by "hardening of the arteries." It is now known that the principal form of dementia, Alzheimer's disease, has no more arteriosclerosis than would be expected based on age. The vasodilators therefore have a poor rationale and are now used infrequently.
Another category of medication is that of the metabolic enhancers, the best-known agent being a combination of ergoloid mesylates(Hydergine). This agent, while not impressive in its results, does have a substantial body of literature to suggest that it may be of mild benefit for some of the symptoms of dementia. A trial of this agent usually extends over several months to determine whether it may be of benefit. A realistic assessment of the value of such medications focuses on whether or not they slow the expected rate of decline. Some believe that the ergoloid mesylates may favorably alter the rate of disease progression.
Lecithin or choline have been used in the attempt to increase the brain chemical acetylcholine, which is known to be reduced in Alzheimer's disease. Lecithin and choline are building blocks in the formation of acetylholine. Tacrine hydrochloride (Cognex) acts to reduce the breakdown of acetylcholine. Initial study reports purported to show impressive gains in cognitive performance and everyday activities of daily living with the use of tacrine (Cognex). Unfortunately, results from large-scale clinical trials were not as impressive. Tacrine (Cognex) may be beneficial to some patients with mild to moderate disease; however, the drug does not stop be progression of the disease and any benefit derived can be expected to deteriorate with time. Realistically, the most that should be expected is a slowing in the progress of the disease by a few months in some patients. Tacrine (Cognex) is approved by the U.S. Food and Drug Administration for the treatment of Alzheimer's disease.
Recently, the Pharmaceutical Research and Manufacturers of America listed sixteen drugs in development for Alzheimer's disease . Eight of these agents were in phase III clinical trials, that is, tests of the effectiveness of the drug in large numbers of patients with Alzheimer's disease.
Get started with latest information about < a href = "http://www.alzheimersadvice.org/" >alzheimer's disease and various disorders like < a href = "http://www.alzheimersadvice.org/deficits-of-alzheimers-disease/communication-or-language-problem" > communication problems , language problems. If you like the above article and you want to publish it in your site or ezine, you may freely do so, you just need to provide a link back to authors site at http://www.alzheimersadvice.org/.
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