Dementia medical therapy

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Dementia Microchapters

Patient Information

Overview

Classification

Causes

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

The mainstay of management of dementia is :

  • Symptomatic
  • Treatment of behavioral disturbances
  • Environmental manipulations to support function
  • Counseling with respect to safety issues.

More precise diagnosis is required for effective management and accurate prognosis. Medical therapy for dementia include:

They increase cholinergic transmission by inhibiting cholinesterase at the synaptic cleft and provide modest symptomatic benefit in some patients with dementia.

Excessive NMDA stimulation can be induced by ischemia and lead to excitotoxicity, suggesting that agents that block pathologic stimulation of NMDA receptors may protect against further damage in patients with vascular dementia.

They have modest benefits in patients with moderate to severe AD[2]

This category includes vitamin E and selegiline [3]

They have modest benefit in delaying functional progression in patients with mild to moderate Alzheimer Disease

References

  1. Orrego F, Villanueva S (October 1993). "The chemical nature of the main central excitatory transmitter: a critical appraisal based upon release studies and synaptic vesicle localization". Neuroscience. 56 (3): 539–55. doi:10.1016/0306-4522(93)90355-j. PMID 7902967.
  2. Reisberg B, Doody R, Stöffler A, Schmitt F, Ferris S, Möbius HJ (April 2003). "Memantine in moderate-to-severe Alzheimer's disease". N Engl J Med. 348 (14): 1333–41. doi:10.1056/NEJMoa013128. PMID 12672860.
  3. Sano M, Ernesto C, Thomas RG, Klauber MR, Schafer K, Grundman M, Woodbury P, Growdon J, Cotman CW, Pfeiffer E, Schneider LS, Thal LJ (April 1997). "A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study". N Engl J Med. 336 (17): 1216–22. doi:10.1056/NEJM199704243361704. PMID 9110909.

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