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memantine aggression agitation

Soo J Yoon, Seong H Choi, Hae R Na, Kyung-Won Park, Eun-Joo Kim, Hyun J Han, Jae-Hong Lee, Young S Shim, Duk L Na
AIM: Memantine is known to be effective in the treatment of the behavioral symptoms of dementia, especially agitation in moderate to severe Alzheimer's disease (AD). However, memantine and rivastigmine patch combination therapy has not been well studied in determining treatment effectiveness with mild to moderate AD patients. METHODS: This was a multicenter, 24-week, prospective, randomized, open-label study design. A total 147 AD patients with Mini-Mental State Examination scores from 10 to 20 were randomly assigned to rivastigmine patch monotherapy and combination therapy with memantine groups...
April 25, 2016: Geriatrics & Gerontology International
Tatjana Prokšelj, Aleš Jerin, Aleš Kogoj
OBJECTIVE: Behavioural symptoms are common in moderate to severe Alzheimer's disease (AD) and are improved by memantine with the most pronounced effect on agitation/aggression. Dextromethorphan in combination with quinidine is the only drug approved by US Food and Drug Administration for the treatment of pseudobulbar affect (PBA) on the basis of efficacy in patients with multiple sclerosis or amyotrophic lateral sclerosis. The aim of our study was to evaluate the efficacy of memantine on PBA in patients with AD...
December 2013: Acta Neuropsychiatrica
Tomasz Gabryelewicz
Cognitive manifestations usually are the primary abnormalities in dementia. In most cases cognitive deterioration arise in association with behavioral disturbances, and may accelerate institutionalization of patients. Noncognitive symptoms are distressing for both patients and their caregivers. These symptoms are described as "behavioral and psychological symptoms of dementia--BPSD" or neuropsychiatric symptoms. BPSD occurs in all types of dementia, and often are among the most prominent symptoms in the clinical course of the disease...
2014: Przegla̧d Lekarski
Pietro Gareri, Daria Putignano, Alberto Castagna, Antonino Maria Cotroneo, Grazia De Palo, Andrea Fabbo, Luigi Forgione, Attilio Giacummo, Roberto Lacava, Saverio Marino, Maurizio Simone, Amedeo Zurlo, Salvatore Putignano
BACKGROUND: Combined therapy of memantine and acetylcholinesterase inhibitors (AChEIs) in patients with Alzheimer's disease (AD) may be associated with higher benefits than either monotherapy. OBJECTIVE: This retrospective multicentric study conducted in seven Italian Ambulatory Centers for Dementia assessed the efficacy and safety of memantine 20 mg/day administered for 6 months in addition to an AChEI in AD patients with worsened cognitive functions and behavioral disorders...
2014: Journal of Alzheimer's Disease: JAD
Nathan Herrmann, Krista L Lanctôt, David B Hogan
BACKGROUND: While there have been no new medications approved for the treatment of Alzheimer's disease (AD) or other dementias in Canada since 2004, the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) reviewed and updated the clinical practice guidelines on the pharmacological management of dementia that were published previously. METHODS: This review focused on the literature for the pharmacological treatment of dementia based on studies published since the third CCCDTD in 2006...
July 8, 2013: Alzheimer's Research & Therapy
Hadas Benhabib, Krista L Lanctôt, Goran M Eryavec, Abby Li, Nathan Herrmann
BACKGROUND: This study aimed to determine whether the Quality of Life in Late-Stage Dementia (QUALID) scale is responsive to changes in behaviour due to therapeutic intervention. METHOD: 31 long-term care residents with moderate to severe AD and agitation/aggression entered a three-month, open-label trial of memantine 10 mg BID. The relationships between the QUALID and BPSD, global improvement, and cognition at baseline and endpoint, as well as the changes in these scales as a result of treatment, were examined...
2013: Canadian Geriatrics Journal: CGJ
Eduardo Cumbo, Leonarda Domenica Ligori
BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) occur in up to 80% of Alzheimer's disease (AD) patients and represent one of the most common reasons for early institutionalization and increase in management costs. OBJECTIVES: This study evaluated the effects of four drugs (memantine, donepezil, rivastigmine, galantamine) in BPSD in AD patients. METHODS: This was a prospective, longitudinal, randomized, open-label, 4-arm, parallel-group, 12-month clinical trial carried out in 177 AD patients...
2014: Journal of Alzheimer's Disease: JAD
Clive Ballard, Anne Corbett
PURPOSE OF REVIEW: Agitation and aggression commonly arise in people with Alzheimer's disease (AD) and other dementias. They are distressing for the individual and often confer risk to them and to others, as well as raising significant clinical challenges. This review outlines the current evidence for pharmacological and nonpharmacological approaches to the treatment of agitation and aggression in these patients. RECENT FINDINGS: There is a growing body of literature supporting the use of nonpharmacological approaches as well as the treatment of pain as a first-line management strategy prior to psychopharmacotherapy...
May 2013: Current Opinion in Psychiatry
Nathan Herrmann, Serge Gauthier, Neli Boneva, Ole Michael Lemming
BACKGROUND: Agitation and aggression in Alzheimer's disease (AD) are amongst the most serious of neuropsychiatric symptoms, and contribute to poor outcomes and worse quality of life. Previous studies have suggested a benefit for memantine on agitation and aggression, but none have examined its efficacy in community-dwelling patients with significant agitation and aggression at baseline, utilizing these behaviors as a primary outcome measure. METHODS: Patients with moderate-to-severe AD with Neuropsychiatric Inventory (NPI) total score ≥13 and NPI agitation/aggression score ≥1 were randomized to placebo or 20-mg memantine in a double-blind, 24-week trial...
June 2013: International Psychogeriatrics
Yu-Jhen Huang, Chieh-Hsin Lin, Hsien-Yuan Lane, Guochuan E Tsai
Dementia has become an all-important disease because the population is aging rapidly and the cost of health care associated with dementia is ever increasing. In addition to cognitive function impairment, associated behavioral and psychological symptoms of dementia (BPSD) worsen patient's quality of life and increase caregiver's burden. Alzheimer's disease is the most common type of dementia and both behavioral disturbance and cognitive impairment of Alzheimer's disease are thought to be associated with the N-methyl-D-aspartate (NMDA) dysfunction as increasing evidence of dysfunctional glutamatergic neurotransmission had been reported in behavioral changes and cognitive decline in Alzheimer's disease...
September 2012: Current Neuropharmacology
Nathan Herrmann, Jaclyn Cappell, Goran M Eryavec, Krista L Lanctôt
BACKGROUND: Agitation and aggression are common neuropsychiatric symptoms of Alzheimer's disease (AD) with a negative impact on caregivers. OBJECTIVE: The aim of the study was to determine whether changes in agitation and aggression would follow memantine treatment and, if so, be associated with changes in nursing burden in institutionalized patients with moderate to severe AD. STUDY DESIGN: This was a 3-month open-label trial of memantine...
May 2011: CNS Drugs
Kelly A Smart, Nathan Herrmann, Krista L Lanctôt
This analysis assessed 3 subscales derived from the nursing home Minimum Data Set (MDS), the Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), and Aggressive Behavior Scale (ABS), as outcome measures in clinical trials of long-term care residents with Alzheimer disease (AD). A total of 26 patients with moderate-to-severe AD and agitation/aggression enrolled in a trial of memantine were assessed using the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory Nursing Home Version (NPI-NH), and the Cohen-Mansfield Agitation Inventory (CMAI) administered by trained researchers...
June 2011: Journal of Geriatric Psychiatry and Neurology
Nathan Herrmann, Abby Li, Krista Lanctôt
INTRODUCTION: As the world's population ages, the incidence of Alzheimer's disease (AD) is projected to double every 20 years. Understanding the pathogenesis of AD and developing effective treatments is a public health imperative. Memantine is a low- to moderate-affinity, non-competitive NMDA receptor antagonist that is currently approved for the treatment of moderate to severe AD. AREAS COVERED: We discuss the current evidence, emphasizing more recent studies examining the effects of memantine in AD...
April 2011: Expert Opinion on Pharmacotherapy
Gerald G Osborn, Amanda Vaughn Saunders
There is neither proven effective prevention for Alzheimer disease nor a cure for patients with this disorder. Nevertheless, a spectrum of biopsychosocial therapeutic measures is available for slowing progression of the illness and enhancing quality of life for patients. These measures include a range of educational, psychological, social, and behavioral interventions that remain fundamental to effective care. Also available are a number of pharmacologic treatments, including prescription medications approved by the US Food and Drug Administration for Alzheimer disease, "off-label" uses of medications to manage target symptoms, and controversial complementary therapies...
September 2010: Journal of the American Osteopathic Association
Clive Ballard, Anne Corbett
Neuropsychiatric symptoms are frequent and troublesome in people with dementia and present a major treatment challenge for clinicians. Most good practice guidelines suggest non-pharmacological treatments as the first-line therapy and there is emerging evidence, including randomized controlled trials, that a variety of psychological and training interventions, including social interaction and person-centred care training, are effective. There is evidence from meta-analyses that some atypical antipsychotic drugs, specifically risperidone and aripiprazole, confer benefit in the treatment of aggression in people with Alzheimer's disease over a period of up to 12 weeks...
September 2010: CNS Drugs
Oana Creţu, Andreea Silvana Szalontay, Roxana Chiriţă, V Chiriţă
OBJECTIVE: Investigating the behavioral and cognitive effect of memantine in moderate to severe patients with Alzheimer's disease receiving donepezil. MATERIAL AND METHOD: 43 patients were enrolled in this prospective, randomized, parallel group study. There were no significant imbalances between the treatment groups in demographic and baseline clinical characteristics. Cognitive and global measures were collected at baseline and at the end of weeks 4, 8, 12 and 24...
July 2008: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
P T Francis
Behavioural symptoms are a significant problem in Alzheimer's disease (AD). Symptoms including agitation/aggression and psychosis reduce patient quality of life, significantly increase caregiver burden, and often trigger nursing home placement. Underlying changes in the serotonergic, noradrenergic and cholinergic systems have been linked to some behavioural problems, however, the use of antipsychotics in this population has been associated with significant safety concerns. A role for the glutamate system in schizophrenia, as well as in anxiety and depression, has been suggested, and evidence is emerging for a role for dysfunctional glutamate neurotransmission (via N-methyl-D-aspartate (NMDA) receptors) in certain behavioural changes in dementia...
January 2009: Current Molecular Pharmacology
Blanca M Bolea-Alamanac, Simon J C Davies, David M Christmas, Hazel Baxter, Sarah Cullum, David J Nutt
Aggressivity is a common problem in the management of elderly patients with dementia. Medications currently used to diminish aggressive behaviour in dementia can have problematic side effects. We present a case and systematic review of the current knowledge about the use of cyproterone acetate to treat aggressivity (excluding hypersexuality related behaviours) in dementia. An 82-year-old man required psychiatric inpatient admission due to agitation and aggressivity and was diagnosed with Alzheimer's disease...
January 2011: Journal of Psychopharmacology
Clive Ballard, Anne Corbett, Ramilgan Chitramohan, Das Aarsland
PURPOSE OF REVIEW: Behavioral and psychological symptoms of dementia (BPSD) are frequent among people with Alzheimer's disease and other dementias, commonly confer risk to the person and others, and present a significant management challenge for clinicians. The purpose of this review is to describe the current state of knowledge regarding management of BPSD, with a particular focus on agitation. RECENT FINDINGS: There is increasing evidence to support the value of simple psychological interventions and staff-training programs as a first-line management strategy for agitation prior to pharmacotherapy...
November 2009: Current Opinion in Psychiatry
Nathan Herrmann, Serge Gauthier, Paul G Lysy
BACKGROUND: Although severe Alzheimer's disease (AD) represents a prevalent, serious, and costly public health problem, few practice guidelines exist to help physicians manage this disorder. METHODS: A search of English language medical databases was performed from 1996 to the present for articles pertaining to the management of AD. The focus of this review was on studies that included patients with severe disease. Studies were assessed by considering the subjects, trial design, analysis, and results...
October 2007: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
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