scholarly journals Efficacy of pharmacological treatment of dementia

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 11-14
Author(s):  
Leon Flicker
Keyword(s):  
Side Effects ◽  
High Risk ◽  
Cholinesterase Inhibitor ◽  
Cholinesterase Inhibitors ◽  
Therapeutic Agents ◽  
Therapeutic Trial ◽  
Cognitive Symptoms ◽  
Considerable Evidence ◽  
People With Dementia ◽  
Functional Symptoms

Over the last 25 years an increasing number of studies have been performed to evaluate therapeutic agents for people with dementia. Although numerous agents have been trialed at this stage there little evidence that therapeutic agents can prevent dementia or ameliorate the progression of dementia of any type. There is some evidence that specific medical management in high risk individuals can prevent strokes, and thus probably prevent vascular dementia, although this is extrapolating from the available evidence. There is considerable evidence that cholinesterase inhibitor are effective for cognitive symptoms in people with mild to moderate AD, and there is some evidence that they are also effective for other behavioural and functional symptoms. The currently available cholinesterase inhibitors seem to have approximately the same sized effect and thus the choice of agent may be largely determined by the incidence of side-effects. These agents have modest effects and a cautious therapeutic trial is indicated for those subjects with mild to moderate AD.

scholarly journals 247 Antipsychotic Medication in the Management of Non-cognitive Symptoms of Dementia: An Updated Evidence Review

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Siobhán Fox ◽  
Ashling Murphy ◽  
Aisling Jennings ◽  
Kieran Murphy ◽  
Suzanne Timmons
Keyword(s):  
Side Effects ◽  
Antipsychotic Medication ◽  
Clinical Decision Making ◽  
Lewy Body Dementia ◽  
Pharmacological Intervention ◽  
Cognitive Symptoms ◽  
Short Term Treatment ◽  
Antipsychotic Medications ◽  
People With Dementia ◽  
Tract Infections

Abstract Background Antipsychotic medications are commonly used in the management of non-cognitive symptoms of dementia (also termed behavioural and psychological symptoms of dementia), such as agitation, calling out, hoarding, or aggression. This is despite increased recognition of adverse effects, including mortality, from these medications for people with dementia. The current aim was to review the most recent evidence for the efficacy and safety of antipsychotic medications in the management of non-cognitive symptoms in dementia. Methods Relevant studies published in English from March 2015 through to March 2018 were identified by searches of 5 databases: Medline, EBSCO, PsycINFO, Cochrane DARE, and Cochrane CENTRAL. Systematic reviews, meta-analyses, and controlled trials evaluating the safety of antipsychotic medication, or comparing the effectiveness of antipsychotic medication with placebo, another antipsychotic medication, or non-pharmacological intervention, were included. Independent article review and data extraction was performed by two reviewers. Study quality was appraised using the Joanna Briggs Institute critical appraisal tools. Results Thirteen studies were included. Benefits and harms vary among antipsychotic medications for people with dementia, however overall efficacy of antipsychotics remains modest at best. A significant number of side effects are associated with antipsychotics, not least cerebrovascular events, sedation, gait disturbances, falls, fractures, urinary tract infections, cognitive worsening, and mortality. Atypical antipsychotics have a more favourable safety profile in some respects. People with certain dementias, notably Lewy Body Dementia, may experience more severe side-effects. Conclusion The evidence reinforces caution when prescribing antipsychotic medications for people with dementia; these medications should only be considered when symptoms are severe or non-pharmacological interventions have failed. Clinicians should closely monitor people with dementia who are prescribed an antipsychotic for side effects, limiting use of these medications to short-term treatment if possible. The forthcoming national clinical guideline for appropriate prescribing of psychotropic medications for non-cognitive symptoms will support clinical decision-making in this regard.

scholarly journals Brain-specific inhibition of mTORC1 eliminates side effects resulting from mTORC1 blockade in the periphery and reduces alcohol intake in mice

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Yann Ehinger ◽  
Ziyang Zhang ◽  
Khanhky Phamluong ◽  
Drishti Soneja ◽  
Kevan M. Shokat ◽  
...  
Keyword(s):  
Side Effects ◽  
Inhibitory Action ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Therapeutic Agents ◽  
Adverse Side Effects ◽  
Mtorc1 Activation ◽  
Potential Use ◽  
Heavy Alcohol Intake ◽  
Alcohol Dependent

AbstractAlcohol Use Disorder (AUD) affects a large portion of the population. Unfortunately, efficacious medications to treat the disease are limited. Studies in rodents suggest that mTORC1 plays a crucial role in mechanisms underlying phenotypes such as heavy alcohol intake, habit, and relapse. Thus, mTORC1 inhibitors, which are used in the clinic, are promising therapeutic agents to treat AUD. However, chronic inhibition of mTORC1 in the periphery produces undesirable side effects, which limit their potential use for the treatment of AUD. To overcome these limitations, we designed a binary drug strategy in which male mice were treated with the mTORC1 inhibitor RapaLink-1 together with a small molecule (RapaBlock) to protect mTORC1 activity in the periphery. We show that whereas RapaLink-1 administration blocked mTORC1 activation in the liver, RapaBlock abolished the inhibitory action of Rapalink-1. RapaBlock also prevented the adverse side effects produced by chronic inhibition of mTORC1. Importantly, co-administration of RapaLink-1 and RapaBlock inhibited alcohol-dependent mTORC1 activation in the nucleus accumbens and attenuated alcohol seeking and drinking.

The use of phytotherapy in diseases caused by parasitic protozoa

2014 ◽  
Vol 60 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Monika Derda ◽  
Edward Hadaś
Keyword(s):  
Side Effects ◽  
Chronic Diseases ◽  
Conventional Treatment ◽  
Therapeutic Agents ◽  
Pharmaceutical Market ◽  
Parasitic Diseases ◽  
Plant Origin ◽  
Parasitic Protozoa ◽  
Herbal Preparations ◽  
Increasing Demand

AbstractThe paper presents an overview of the use of natural therapeutic agents in combating parasitic diseases. Nowadays there is increasing demand for proven plant therapies, which often are found to be more effective than synthetic pharmaceuticals in chronic diseases. In many cases herbal preparations perfectly supplement the conventional treatment and at the same time do not cause side effects. On the pharmaceutical market there are many drugs of plant origin which have been applied in the treatment of parasitic diseases. However, researchers are still looking for new plants, or specific substances isolated from them, which can be used in therapy. In this paper, drugs of plant origin used in the treatment of amoebiasis, giardiasis, malaria, leishmaniasis, trypanosomiasis and acanthamoebiasis are described.

scholarly journals Clinical and Therapeutic Trial for the Efficacy of Narrow Band - UVB Phototherapy versus Systemic Therapy in Moderate and Severe Atopic Dermatitis of the Adult

2018 ◽  
Vol 64 (1) ◽  
pp. 17-21
Author(s):  
Gyula Laszlo Fekete ◽  
László Fekete
Keyword(s):  
Atopic Dermatitis ◽  
Side Effects ◽  
Systemic Therapy ◽  
Systemic Corticosteroid ◽  
Corticosteroid Treatment ◽  
Serum Levels ◽  
Severe Atopic Dermatitis ◽  
Therapeutic Trial ◽  
Group I ◽  
Uvb Phototherapy

AbstractObjectives: The aim of this clinical and therapy study was to evaluate the efficacy of NB-UVB phototherapy versus systemic therapy in moderate-to-severe atopic dermatitis of the adult.Material and methods: The subjects of the study were divided into two groups of 25 adult patients with moderate and severe atopic dermatitis according to the inclusion criteria. The first group of 25 patients were treated with systemic corticosteroids while the second group of 25 patients were treated with NB-UVB phototherapy. At the end of the study, after all the data were centralized, we performed a statistical analysis of the results, comparing the two groups as well as the efficacy of the different therapies.Results: In group I the clinical efficacy of the systemic corticosteroid treatment was achieved, on average, at 4 weeks in patients with moderate atopic dermatitis and at 6 weeks in patients with severe atopic dermatitis. In group II the clinical effecacy of NB-UVB phototherapy was achieved, on average, at 6 weeks for patients with moderate atopic dermatitis and at 8 weeks for those with the severe form. In both groups, the total IgE serum levels were elevated at the beginning, and they became normal throughout the clinical improvement. Remarkable therapy-related side effects were found in the first study group.Conclusion: We conclude that NB-UVB phototherapy had similar efficacy in treating moderate-to-severe atopic dermatitis with minimal side effects compared to systemic corticosteroid therapy.

scholarly journals PEMILIHAN KONTRASEPSI BERDASARKAN EFEK SAMPING PADA DUA KELOMPOK USIA REPRODUKSI

2017 ◽  
Vol 6 (3) ◽  
pp. 167
Author(s):  
Erna Setiawati ◽  
Oktia Woro Kasmini Handayani ◽  
Asih Kuswardinah
Keyword(s):  
Side Effects ◽  
High Risk ◽  
Random Sampling ◽  
High Risk Pregnancy ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Risk Pregnancy

ABSTRACT Kelompok usia reproduksi terbagi dalam tiga fase yaitufase menunda kehamilan (<20 tahun), fase menjarangkan kehamilan (20-30 tahun) dan fase mengakhiri kehamilan (>30 tahun). Cara yang ditempuh yaitu dengan pemakaian kontrasepsi.baik  MKJPmaupunnon MKJP. Tujuan penelitian ini adalah untuk mengetahui ada atau tidak perbedaan pemilihan kontrasepsi MKJP dan non MKJP berdasarkan efek samping pada dua kelompok usia reproduksi. Penelitin ini menggunakan desain cross sectional, pengambilan data dengan kuesioner. Sampel dalam penelitian ini adalah akseptor KB baik MKJP maupun non MKJP pada bulan april sampai juni sebanyak 200 responden, dimana tekhnik pengambilan datanya dengan random sampling dan kuota sampling. Hasil penelitian kemudian diuji dengan mann-whitney test.Hasil penelitian dengan uji mann whitney test diperoleh p = 0.662 dengan kata lain p > α (0.05) yang berarti tidak ada perbedaan pemilihan MKJP dan non MKJP berdasarkan efek samping di Wilayah Kabupaten Semarang.      ABSTRACT Reproductive-age category can be divided into three groups which are the group of delayed interval pregnancy (less than 20 years old), the group of intervalcontrol pregnancy (20 to 30 years old), and the group of high risk pregnancy (more than 30 years old). An alternative to avoid high risk pregnancy is by using contraception tool namely long-term contraception (MKJP) and non long-term contraception (non MKJP).The purpose of this research is to analysedwhether there are differences in choosing MKJP and non –MKJP based on side effects in the two reproductive-age groups.This research was an explanatory research with cross-sectional design. The population were all women of contraception acceptors in Semarang Regency.The samples were 200 respondents, used simple random sampling and quota sampling. This research used quisionaire instrument and analyze used mann whitney test (α=0,05). Theresult showed thatP = 0,662 meaning P > α = 0.05 which means there is no difference in choosing MKJP and non-MKJP based on side effects in the two reproduction-age groups in Semarang regency.

scholarly journals BDNF as a Biomarker of Cognition in Schizophrenia/Psychosis: An Updated Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Rodrigo R. Nieto ◽  
Andrea Carrasco ◽  
Sebastian Corral ◽  
Rolando Castillo ◽  
Pablo A. Gaspar ◽  
...  
Keyword(s):  
Cognitive Function ◽  
High Risk ◽  
Human Subjects ◽  
Chronic Schizophrenia ◽  
Review Article ◽  
First Episode ◽  
Cognitive Symptoms ◽  
Research Gaps ◽  
Future Developments ◽  
The Relationship

Brain Derived Neurotrophic Factor (BDNF) has been linked to cognitive symptoms of schizophrenia, which has been documented in previous reviews by several authors. However, a trend has recently emerged in this field moving from studying schizophrenia as a disease to studying psychosis as a group. This review article focuses on recent BDNF studies in relation to cognition in human subjects during different stages of the psychotic process, including subjects at high risk of developing psychosis, patients at their first episode of psychosis, and patients with chronic schizophrenia. We aim to provide an update of BDNF as a biomarker of cognitive function on human subjects with schizophrenia or earlier stages of psychosis, covering new trends, controversies, current research gaps, and suggest potential future developments in the field. We found that most of current research regarding BDNF and cognitive symptoms in psychosis is done around schizophrenia as a disease. Therefore, it is necessary to expand the study of the relationship between BDNF and cognitive symptoms to psychotic illnesses of different stages and origins.

Magnesium Sulphate for Seizure Prophylaxis in Women With Preeclampsia

2021 ◽  
pp. 1-6
Author(s):  
Peter Lindner ◽  
Shad Deering
Keyword(s):  
Side Effects ◽  
High Risk ◽  
Randomized Trial ◽  
Magnesium Sulphate ◽  
Neonatal Death ◽  
Maternal Morbidity ◽  
Controlled Trial ◽  
Before And After ◽  
Secondary Outcomes ◽  
High Risk Cohort

The article “Do Women With Pre-Eclampsia, and Their Babies, Benefit From Magnesium Sulphate? The Magpie Trial: A Randomized Placebo-Controlled Trial” is the first randomized trial that objectively evaluates the utility of magnesium sulphate therapy as prophylaxis against progression to eclamptic convulsions in a high-risk cohort of women. It specifically evaluates the effect of magnesium sulphate given before and after delivery on maternal progression to eclampsia and fetal/neonatal death. It also evaluates secondary outcomes such as maternal morbidity; magnesium toxicity; side effects of magnesium sulphate; and, for those who received magnesium sulphate prior to delivery, it evaluated complications of the labor process.

Psychopathology

2016 ◽  
pp. 147-170 ◽  
Author(s):  
Eduardo Fonseca Pedrero ◽  
Diane C. Gooding ◽  
Martin Debbané ◽  
José Muñiz
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
High Risk ◽  
Mental States ◽  
Psychological Process ◽  
Cognitive Symptoms ◽  
Need For Care ◽  
Measurement Instruments ◽  
Psychosis Risk ◽  
Higher Cognitive Functions

This chapter reviews the assessment of psychopathology, with a focus on psychosis and clinically related phenomena and conditions, such as prodromal phases and at-risk mental states of psychosis. The psychosis syndrome, which is characterized by a disruption of higher cognitive functions, can be found when any basic psychological process (e.g., memory, attention, etc.) is altered. It is used here as an example of psychopathological disorder. The chapter begins with an overview of the psychosis syndrome as a model of psychopathological disorder, emphasizing its core domains (i.e., positive, negative, and cognitive symptoms). It discusses the main psychological tests and procedures for psychosis assessment and provides an overall review of measurement instruments for psychosis risk assessment from both clinical and psychometric high-risk paradigms, where psychological testing plays a crucial role in terms of detecting people at risk for psychosis prior to developing serious mental disorder and need for care.

6081Efficacy and limitations of quinidine therapy in patients with Brugada Syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Mazzanti ◽  
E Tenuta ◽  
M Marino ◽  
E Pagan ◽  
M Morini ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Side Effects ◽  
High Risk ◽  
Brugada Syndrome ◽  
Low Dose ◽  
Clinical Course ◽  
High Risk Group ◽  
High Dose ◽  
Life Threatening ◽  
Patients Experience

Abstract Background Quinidine at high-dose is used in patients with Brugada Syndrome (BrS), but its efficacy to prevent life-threatening arrhythmic events (LAE) in BrS is unproven and its use is limited by side effects. Objective We assessed whether low-dose quinidine in BrS patients reduces: 1) the occurrence of a first LAE; 2) the arrhythmic burden in the high-risk group of cardiac arrest survivors. Methods We first compared the clinical course of 53 BrS patients treated with quinidine to that of 441 untreated controls, matched by sex, age, and symptoms. Furthermore, we calculated the annual incidence of LAEs off- and on-quinidine in 123 BrS patients who had survived a cardiac arrest. Results First, we compared the clinical course of 53 BrS patients treated with quinidine (i.e. “cases”: 89% males, median age 40 years) to that of 441 untreated, clinically-matched BrS patients (i.e. “controls”: 91% males, median age 41 years) present in our database of patients with inherited arrhythmias. Cases received quinidine (median dose of 450 mg per day) for 5.0±3.7 years. Quinidine was interrupted in only 3/53 cases (6%) for side effects and it conferred a nonsignificant reduction of the risk of a first LAE in cases versus controls (HR 0.74, 95% CI 0.22–2.48, P=0.62). Secondly, we calculated the annual recurrence of LAE off- and on-quinidine in 123 BrS cardiac arrest survivors, 27 of whom were treated with quinidine for 7.0±3.5 years. The annual rate of recurrent LAEs decreased significantly from 14.7% while off-quinidine to 3.9% while on-quinidine (P=0.03). Notably, recurrent life-threatening arrhythmic events were recorded in 4/27 (15%) symptomatic patients while on-quinidine. Conclusion We demonstrated for the first time in the long-term that low-dose quinidine reduces the recurrence of life-threatening arrhythmias in symptomatic BrS patients, with few side effects. Remarkably, about one-fifth of symptomatic patients experience life-threatening arrhythmias while on-treatment, suggesting that quinidine cannot replace implantable defibrillators in high-risk subjects.

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