scholarly journals Antipsychotics in dementia: are they being appropriately prescribed?

2010 ◽  
Vol 22 (3) ◽  
pp. 501-502 ◽  
Author(s):  
Fozia Roked ◽  
Asha Omar ◽  
Fayaz Roked ◽  
Ridwan Ahmed ◽  
Abdul Patel
Keyword(s):  
Adverse Effects ◽  
Atypical Antipsychotics ◽  
The Elderly ◽  
Qt Prolongation ◽  
Patient Organizations ◽  
People With Dementia ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Excessive Sedation ◽  
Typical And Atypical Antipsychotics

In 2007, the U.K.'s All-Party Parliamentary Group on Dementia (APPG) undertook an inquiry into the prescription of antipsychotics for people with dementia on account of concerns expressed by carers, patient organizations and academics about the appropriateness and safety of these drugs (All-Party Parliamentary Group on Dementia, 2008). It has been estimated that 32% of patients with dementia in care homes are prescribed antipsychotics (Alldred et al., 2007). Both typical and atypical antipsychotics are associated with QT prolongation, which can lead to arrhythmias and sudden death (Joint Formulary Committee, 2009). They are also associated with an increased risk of cerebrovascular events. Adverse effects in the elderly include excessive sedation and dizziness, which can lead to falls and therefore accelerated cognitive decline.

scholarly journals The Effect of Dance and Movement Therapy on Balance and Depression of the Elderly Who Are Sick with Dementia

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Dovilė Štrimaitytė ◽  
Gražina Krutulytė ◽  
Kristina Žigienė
Keyword(s):  
Muscle Power ◽  
Dynamic Balance ◽  
The Elderly ◽  
Movement Therapy ◽  
Old People ◽  
Symptoms Of Depression ◽  
The People ◽  
People With Dementia ◽  
Keywords Dementia ◽  
Increased Risk

The subject of the research: The effect of dance and movement therapy.The problem of the research: Years are going on and old people meet a problem that their gait changes, their balance becomes worse and the muscle power decreases. People who have cognitive impairment frequently demonstrate disturbed gait which put them into an increased risk to fall down and get injured seriously. Patients who are sick with dementia very often experience symptoms of depression the treatment of which is investigated insufficiently. It is known that dance and movement therapy positively impacts the health of the people with dementia, improves their emotions and mental conditions. Many foreign scientists investigate how dance and movement therapy affects old people’s balance, depression, but the following indexes of people who are sick with dementia are not researched. In Lithuania no pharmacological treatment of dementia is popular. Nowadays in our country there is no research about the effect of dance and movement therapy’s effect on people who are sick with dementia, how it impacts their depression and static and dynamic balance. The hypothesis of the research: Dance and movement therapy can improve static and dynamic balance and reduce depression of the elderly who are sick with dementia The aim of the research was to evaluate the effect of dance and movement therapy on balance and depression of the elderly who are sick with dementia: The goals of the research were: To establish the effect of dance and movement therapy to static and dynamic balance for old people sick with dementia. To establish the effect of dance and movement therapy for depression of old people sick with dementia. Several conclusions were made in on the basis of the results of this study: Dance and movement therapy can help improve static and dynamic balance for the elderly with dementia (p < 0. 05). Dance and movement therapy can help reduce depression of the elderly with dementia (p < 0.05).Keywords: dementia, balance, depression, dance and movement therapy.

Adverse Effects of Atypical Antipsychotics in the Elderly

Drugs & Aging ◽  
2006 ◽  
Vol 23 (12) ◽  
pp. 937-956 ◽  
Author(s):  
Pietro Gareri ◽  
Pasquale De Fazio ◽  
Salvatore De Fazio ◽  
Norma Marigliano ◽  
Guido Ferreri Ibbadu ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Atypical Antipsychotics ◽  
The Elderly

Risperidone treatment in elderly patients with dementia: relative risk of cerebrovascular events versus other antipsychotics

2005 ◽  
Vol 17 (4) ◽  
pp. 617-629 ◽  
Author(s):  
Sanford Finkel ◽  
Chris Kozma ◽  
Stacey Long ◽  
Andrew Greenspan ◽  
Ramy Mahmoud ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Atypical Antipsychotics ◽  
Reference Group ◽  
Wide Spectrum ◽  
Patient Characteristics ◽  
Antipsychotic Treatment ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Significant Difference ◽  
Treatment Alternatives

Background:The possibility that low-dose antipsychotic treatment is associated with increased risk of cerebrovascular events (CVEs) in elderly patients with dementia has been raised. The objective was to determine whether risperidone is associated with an increased risk of CVEs relative to other commonly considered alternative treatments.Methods:An analysis of Medicaid data from 1999 to 2002, representing approxi-mately 8 million enrollees from multiple states, was conducted. The primary outcome was the incidence of acute inpatient admission for a CVE within 3 months following initiation of treatment with atypical antipsychotics (risperidone, olanzapine, quetiapine, or ziprasidone), haloperidol, or benzo-diazepines.Results:Descriptive analyses found similar rates of incident CVEs across evaluated agents. Multivariate analyses found no differences in comparisons of risperidone with olanzapine or quetiapine. Risperidone and other antipsychotics as a group were also not associated with a higher odds ratio (OR) of incident CVE than either haloperidol or benzodiazepines. With risperidone as the reference group: olanzapine, OR=1.05, 95% CI 0.63–1.73; quetiapine, OR=0.66, 95% CI 0.23–1.87; haloperidol, OR=1.91, 95% CI 1.02–3.60; benzodiazepines, OR=1.97, 95% CI 1.30–2.98. With benzodiazepines as the reference group, the OR of incident CVE for all antipsychotics as a class was 0.49, 95%CI 0.35–0.69.Conclusions:This study found no significant difference in the incidence of CVEs between patients taking risperidone and those taking other atypical antipsychotics. Risperidone and all atypical antipsychotics were not associated with higher risk than two common treatment alternatives (haloperidol and benzodiazepines). These findings do not support the conclusion that risperidone is associated with a higher risk of CVE than other available treatment alternatives. The data also suggest that patient characteristics other than antipsychotic use are more significant predictors of CVEs. Given the relatively low rates of incident CVEs, a larger sample of patients with groups closely balanced on a wide spectrum of potential risk factors could provide a more precise assessment of risk.

scholarly journals Use of metoclopramide associated with the risk of developing extrapyramidal symptoms: a literature review

2021 ◽  
Author(s):  
Daniela Videira Botton ◽  
Daisi Sanches Moraes ◽  
Rafaela Tavares Mendes ◽  
Letícia Pereira Mourão ◽  
Wilson Roberto Malfará
Keyword(s):  
Literature Review ◽  
Adverse Effects ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Positive Association ◽  
The Elderly ◽  
Extrapyramidal Symptoms ◽  
High Exposure ◽  
Pubmed Database ◽  
Increased Risk

Background: Parkinsonism is an extrapyramidal syndrome characterized by the presence of tremor, akinesia and stiffness. Metoclopramide is a substance with antiemetic properties, and the mechanism of action is an antagonism of the dopamine D2 receptor. Thus, it presents adverse effects, such as dyskinesia, dystonia, hypertonia and tremor. Accordingly, studies associate the use of metoclopramide with an increased risk of developing extrapyramidal effects. Objectives: The aimed is describe the association between the use of metoclopramide and the risk of developing extrapyramidal symptoms. Methods: A literature review was carried out based on articles from the PubMed database, totaling 10 articles. The keywords used for the selection of articles were: metoclopramide, extrapyramidal and parkinsonism. Results: A case study noted that the use of metoclopramide leads to a dopamine deficiency, which may be involved in the etiology of parkinsonism, as a patient already diagnosed with Parkinson’s disease developed an exacerbation after using metoclopramide. Another study showed that the use of metoclopramide in the elderly population was considered a risk factor for adverse effects such as involuntary movements. A cohort study described a positive association between the use of oral metoclopramide and an increased risk of developing parkinsonism, considered as an important side effect in high-exposure, older users and with other morbidities. Conclusions: Therefore, it was evident that an association between metoclopramide and the development of extrapyramidal symptoms is strongly indicated by the studies analyzed, which suggests caution in the prescription of this pharmacological class.

Typical and Atypical Antipsychotics in Adolescent Schizophrenia: Efficacy, Tolerability, and Differential Sensitivity to Extrapyramidal Symptoms

1998 ◽  
Vol 43 (6) ◽  
pp. 596-604 ◽  
Author(s):  
Ralph Lewis
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Children And Adolescents ◽  
Atypical Antipsychotics ◽  
Dose Range ◽  
Young Patients ◽  
Extrapyramidal Symptoms ◽  
New Drugs ◽  
Differential Sensitivity ◽  
Typical And Atypical Antipsychotics

Objective: To review the existing literature on the efficacy and tolerability of antipsychotics for adolescent psychosis. The review focuses in particular on literature regarding adverse effects that are thought to have an increased incidence in young patients and on the possible neurobiological bases for such differential sensitivity. Method: Pertinent studies were sought using Medline searches, supplemented by selected bibliographies, and reviewed. Results: There is a relative paucity of research in this area; in particular, well-controlled trials are lacking. The existing literature suggests fairly good efficacy of both typical and atypical antipsychotics in the treatment of psychotic disorders in children and adolescents. However, the incidence of certain side effects, particularly extrapyramidal symptoms (EPS), is found to be higher in young patients compared with adults. Positron emission tomography (PET) receptor studies in adults have demonstrated that the incidence of EPS is related to dose-dependent dopamine type-2 (D2) receptor occupancy and that there is a significant relationship between the number of these receptors and age. Conclusions: Improved tolerability is leading to the increasing use of atypical antipsychotics for adolescent patients, though these new drugs do have specific adverse effects of their own. There is a need for more controlled studies of atypical antipsychotics in children and adolescents. In particular, dose-finding studies are needed to determine the optimal dose range to produce the greatest improvement with the least side effects for each of these new drugs.

scholarly journals Hydroxychloroquine with or without macrolide and standard of care versus standard of care alone for COVID-19 cases: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Dhan Bahadur Shrestha ◽  
Pravash Budhathoki ◽  
Sitaram Khadka ◽  
Era Rawal
Keyword(s):  
Adverse Effects ◽  
Clinical Relevance ◽  
Meta Analysis ◽  
Specific Treatment ◽  
Standard Of Care ◽  
Qt Prolongation ◽  
Cochrane Library ◽  
Cardiac Complications ◽  
Treatment Needs ◽  
Increased Risk

Abstract Background: Coronavirus disease (COVID-19) pandemic has been a global health threat. The specific treatment of this disease has not yet been approved. In this review, we aimed at assessing the role of hydroxychloroquine with/without macrolide in terms of efficacy and adverse effects against the standard of care. Methods: Pubmed, Medline, Google Scholar, Cochrane Library, and Clinicaltrials.gov were searched for the quantitative and qualitative synthesis of 13 studies using PRISMA guidelines for a proper review. Assessment of heterogeneity was done using the I-squared (I2) test and fixed/random effect analysis was done to determine the odds/risk ratio among the selected studies.Results: Meta-analysis of our study demonstrated no significant differences in improvement for the virological cure (RR 0.95, 0.67-1.34), whereas a significant relationship was there in radiological progression (pneumonia resolution) (RR 1.40, 1.03-1.91) between the two arms. There are 1.52 times the odds of intubation during treatment (CI 0.61-3.77), 1.08 times the risk of mortality (CI 0.65-1.79), and about 2.21 times increased risk of development of adverse effect (OR 2.21, 0.95-5.17). Though overall it is of no statistical significance, clinical relevance to thinking while using the treatment for COVID-19 is advised. Among randomized controlled trials, the treatment group has 3.5 times (OR 3.48, 1.64-7.42) higher risk of developing adverse effects. There is 2.5 times the likelihood of severe arrhythmias and QT prolongation (OR 2.49, 1.67-3.70) on the treatment arm compared to control.Conclusion: Hydroxychloroquine with/without macrolide has shown no beneficial effect in viral clearance, survival rates while shows significant relation with the radiological improvement compared to standard of care but may increase the risk of intubation, overall side effects, and cardiac complications like arrhythmias and QT prolongation. Thus utilizing this treatment needs to be judged in clinical relevance and proper monitoring.

Experience with the Atypical Antipsychotics - Risperidone and Olanzapine in the Elderly

1999 ◽  
Vol 11 (3) ◽  
pp. 113-118 ◽  
Author(s):  
Subramoniam Madhusoodanan ◽  
Padma Suresh ◽  
Ronald Brenner ◽  
Renuka Pillai
Keyword(s):  
Atypical Antipsychotics ◽  
The Elderly

Assessment of the Therapeutic Effect of Physiotherapy on Minimizing Imbalances of Geriatric Patients

2020 ◽  
Vol 62 (2) ◽  
pp. 86-91
Author(s):  
Justyna Pawlak ◽  
Małgorzata Dudkiewicz ◽  
Łukasz Kikowski
Keyword(s):  
Quality Of Life ◽  
Therapeutic Effect ◽  
Body Mass ◽  
Geriatric Patients ◽  
The Elderly ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Climbing Stairs ◽  
Tinetti Test

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.

Sign in / Sign up

Export Citation Format

Share Document