Neuropharmacology of the Neuropsychiatric Symptoms of Dementia and Role of Pain: Essential Oil of Bergamot as a Novel Therapeutic Approach

Aging of the population makes of dementia a challenge for health systems worldwide. The cognitive disturbance is a serious but not the only issue in dementia; behavioral and psychological syndromes known as neuropsychiatric symptoms of dementia remarkably reduce the quality of life. The cluster of symptoms includes anxiety, depression, wandering, delusions, hallucinations, misidentifications, agitation and aggression. The pathophysiology of these symptoms implicates all the neurotransmitter systems, with a pivotal role for the glutamatergic neurotransmission. Imbalanced glutamatergic and GABAergic neurotransmissions, over-activation of the extrasynaptic N-methyl-D-aspartate (NMDA) receptors and alterations of the latter have been linked to the development of neuropsychiatric symptoms experienced by almost the entire demented population. Drugs with efficacy and safety for prevention or long term treatment of these disorders are not available yet. Aromatherapy provides the best evidence for positive outcomes in the control of agitation, the most resistant symptom. Demented patients often cannot verbalize pain, resulting in unrelieved symptoms and contributing to agitation. Bergamot essential oil provides extensive preclinical evidence of analgesic properties. Incidentally, the essential oil of bergamot induces anxyolitic-like effects devoid of sedation, typical of benzodiazepines, with a noteworthy advantage for demented patients. These data, together with the reported safety profile, form the rational basis for bergamot as a neurotherapeutic to be trialed for the control of behavioral and psychological symptoms of dementia.

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Cognitive Treatment for OCD

10.1093/oxfordhb/9780195376210.013.0076 ◽

2012 ◽

Author(s):

Maureen L. Whittal ◽

Melisa Robichaud

Keyword(s):

Term Treatment ◽

Future Directions ◽

Cognitive Treatment ◽

Long Term Treatment ◽

Inflated Responsibility ◽

And Control ◽

The Relationship ◽

Control Of Thoughts

The cornerstone of cognitive treatment (CT) for OCD is based upon the knowledge that unwanted intrusions are essentially a universal experience. As such, it is not the presence of the intrusion that is problematic but rather the associated meaning or interpretation. Treatment is flexible, depending upon the nature of the appraisals and beliefs, but can include strategies focused on inflated responsibility and overestimation of threat, importance and control of thoughts, and the need for perfectionism and certainty. The role of concealment and the relationship to personal values are important maintaining and etiological factors. The short-term and long-term treatment outcome is reviewed, along with predictors of treatment response and mechanisms of action, and the chapter concludes with future directions regarding CT for OCD.

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Defining the role of SGAs in the long-term treatment of bipolar disorder

Bipolar Disorders ◽

10.1111/bdi.12472 ◽

2017 ◽

Vol 19 (1) ◽

pp. 65-67 ◽

Cited By ~ 4

Author(s):

Gin S Malhi ◽

Grace Morris ◽

Amber Hamilton ◽

Tim Outhred ◽

Pritha Das

Keyword(s):

Bipolar Disorder ◽

Term Treatment ◽

Long Term Treatment

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Distribution of strontium and mineralization in iliac bone biopsies from osteoporotic women treated long-term with strontium ranelate

Acta Endocrinologica ◽

10.1530/eje-11-0415 ◽

2011 ◽

Vol 165 (3) ◽

pp. 469-476 ◽

Cited By ~ 26

Author(s):

Audrey Doublier ◽

Delphine Farlay ◽

Mohamed T Khebbab ◽

Xavier Jaurand ◽

Pierre J Meunier ◽

...

Keyword(s):

Bone Mineralization ◽

Progressive Increase ◽

Tissue Level ◽

Term Treatment ◽

Iliac Bone ◽

X Ray ◽

Long Term Treatment ◽

Bone Biopsies

ObjectiveTo investigate interactions between strontium (Sr) and bone mineral and its effects on mineralization in osteoporotic women treated long-term with Sr ranelate (SrRan).DesignIn this study, 34 iliac bone biopsies were analyzed after 2, 12, 24, 36, 48, and 60 months of treatment with SrRan.MethodsSr global distribution was analyzed by X-ray cartography and the percentage of bone area containing Sr was calculated in the bone samples. The focal distribution of Sr in all bone samples was investigated by X-ray microanalysis. The degree of mineralization was assessed by quantitative microradiography.ResultsAbsent from old bone formed before the beginning of treatment, Sr was exclusively present in bone formed during this treatment with a much higher focal Sr content in new bone structural units than in old ones. A progressive increase in the extent of areas containing Sr was observed during treatment. The focal bone Sr content in recently formed bone was constant over treatment. Secondary mineralization was maintained at a normal level during treatment.ConclusionThus, the quality of bone mineralization (density and heterogeneity at tissue level) was preserved after a long-term treatment with SrRan.

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The crystal arthropathies

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738013499319 ◽

2013 ◽

Vol 6 (11) ◽

pp. 681-687 ◽

Cited By ~ 1

Author(s):

Robert A Jones ◽

Brian Quilty

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Inflammatory Arthritis ◽

Term Treatment ◽

Routine Practice ◽

Treatment Goals ◽

Crystal Arthropathies ◽

Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

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The relevance of prescribing triple neurohormonal blockade in real clinical practice: the role of mineralocorticoid receptor antagonists

Consilium Medicum ◽

10.26442/20751753.2021.6.200889 ◽

2021 ◽

Vol 23 (6) ◽

pp. 491-497

Author(s):

Igor V. Zhirov ◽

◽

Igor V. Zhirov ◽

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Mineralocorticoid Receptor ◽

Systolic Dysfunction ◽

Term Treatment ◽

Mineralocorticoid Receptor Antagonists ◽

Long Term Treatment ◽

Real Clinical Practice

In the article is outlined the main concepts use of the mineralocorticoids receptors antagonists in the treatment of congestive heart failure and systolic dysfunction after acute myocardial infarction. Claimed the pivotal role of eplerenone in the long-term treatment strategy due to decrease of mortality and improving the clinical outcomes.

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Concerns and Quality of Life of Cancer Survivors Across the Survivorship Trajectory: A Singapore Perspective

10.21203/rs.2.14780/v1 ◽

2019 ◽

Author(s):

Gek Phin Chua ◽

Quan Sing Ng ◽

Hiang Khoon Tan ◽

Whee Sze Ong

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Cancer Treatment ◽

Cancer Survivorship ◽

Recurrence Risk ◽

Term Treatment ◽

Fear Of Recurrence ◽

Long Term Treatment

Abstract Background The aim of this study is to determine the main concerns of survivors at various stages of the cancer survivorship of the cancer survivorship trajectory and to assess whether these concerns have any effect on their quality of life (QOL). The overall goal was to use the insights from the study to guide practice on patient care. Methods A cross-sectional survey of 1107 cancer survivors diagnosed with colorectal, breast, lung, gynaecological, prostate or liver cancers from a cancer centre in Singapore. Eligible patients self-completed a questionnaire adapted from the Mayo Clinic Cancer Centre’s Cancer Survivors Survey of Needs. Results The top 5 concerns among all survivors were cancer treatment and recurrence risk (51%), followed by long-term treatment effects (49%), fear of recurrence (47%), financial concerns (37%) and fatigue (37%). Cancer treatment and recurrence risk, long-term treatment effects and fear of recurrence were amongst the top concerns across the survivorship trajectory. Mean QOL was 7.3 on a scale of 0 – 10. Completed treatment patients had higher QOL score than the newly diagnosed and on treatment patients and the patients dealing with recurrence or second cancer patients. Predictors for QOL included the economic status and housing type of patients and whether patients were concerned with pain and fatigue Conclusion This study confirms that cancer survivors in Singapore face multiple challenges and had various concerns at various stages of cancer survivorship, some of which negatively affect their QOL It is critical to design patient care delivery that appropriately address the various concerns of cancer survivors in order for them to cope and improve their QOL.

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