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https://www.readbyqxmd.com/read/27851868/pharmacotherapies-for-sleep-disturbances-in-dementia
#1
REVIEW
Jenny McCleery, Daniel A Cohen, Ann L Sharpley
BACKGROUND: Sleep disturbances, including reduced nocturnal sleep time, sleep fragmentation, nocturnal wandering, and daytime sleepiness are common clinical problems in dementia, and are associated with significant caregiver distress, increased healthcare costs, and institutionalisation. Drug treatment is often sought to alleviate these problems, but there is significant uncertainty about the efficacy and adverse effects of the various hypnotic drugs in this vulnerable population. OBJECTIVES: To assess the effects, including common adverse effects, of any drug treatment versus placebo for sleep disorders in people with dementia, through identification and analysis of all relevant randomised controlled trials (RCTs)...
November 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27751669/review-of-safety-and-efficacy-of-sleep-medicines-in-older-adults
#2
REVIEW
Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
November 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27727261/-trazodone-contramid%C3%A2-in-clinical-practice-personalizing-antidepressant-intervention
#3
Andrea Fagiolini, Giovanni Amodeo, Arianna Goracci, Patrizia Blardi
AIM: This paper examines the use of Trazodone Contramid® in major depressive disorder (MDD), with a focus on practical guidance regarding real world challenges. The paper includes clinical case reports, developed for didactic reasons, which detail the practical management with Trazodone Contramid® of patients with MDD and either insomnia or anxiety or dementia or isolated (ipo)manic symptoms, which often fulfill the criteria for a diagnosis of MDD with with anxious distress or MDD with mixed features, according to the new DSM-5 classification...
July 2016: Rivista di Psichiatria
https://www.readbyqxmd.com/read/27241038/changing-pattern-of-sedative-use-in-older-adults-a-population-based-cohort-study
#4
Andrea Iaboni, Susan E Bronskill, Katelyn B Reynolds, Xuesong Wang, Paula A Rochon, Nathan Herrmann, Alastair J Flint
BACKGROUND: Benzodiazepine medications have well-documented side effects, and their prescription rates in older adults have been declining. Trazodone and quetiapine are medications with sedative properties when used at low doses and are commonly used off-label for sleep or behavioral symptoms in older adults. OBJECTIVE: Our objective was to describe the shifting patterns of sedative prescription in older adults over time by comparing changes in benzodiazepine, trazodone, and quetiapine dispensing between community and long-term care settings...
July 2016: Drugs & Aging
https://www.readbyqxmd.com/read/26332220/interventions-for-neuropsychiatric-symptoms-in-neurocognitive-impairment-due-to-alzheimer-s-disease-a-review-of-the-literature
#5
REVIEW
Tamela D McClam, Christopher M Marano, Paul B Rosenberg, Constantine G Lyketsos
Neurocognitive impairment due to Alzheimer's disease (previously termed Alzheimer's dementia) (AD) is the most common form of cognitive impairment worldwide. Given the anticipated increase in the population aged 65 and over, the prevalence of persons with AD is expected to increase exponentially during the next 30 years. Noncognitive neuropsychiatric symptoms (NPS) commonly occur in AD and are associated with adverse outcomes for patients and their caregivers. This review summarizes randomized, controlled trials (RCTs) published between 2004 and 2014 with a primary outcome measure of change in symptom severity for NPS in AD...
September 2015: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/26088119/off-label-trazodone-prescription-evidence-benefits-and-risks
#6
REVIEW
Letizia Bossini, Anna Coluccia, Ilaria Casolaro, Jim Benbow, Giovanni Amodeo, Riccardo De Giorgi, Andrea Fagiolini
Although trazodone is approved and marketed in most countries worldwide for the sole treatment of Major Depressive Disorder, the use for this medication is very common for many other conditions, such as primary or secondary insomnia, Generalised Anxiety Disorder, Panic Disorder, Post-Traumatic Stress Disorder and Obsessive- Compulsive Disorder. Other, not officially approved, uses of trazodone include: the treatment of bulimia, benzodiazepine and/or alcohol dependence or abuse, fibromyalgia, degenerative diseases of the central nervous system such as dementia and other organic disorders, schizophrenia, chronic pain, and diabetic neuropathy...
2015: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/25946052/outpatient-treatment-of-sleep-disorders-in-alzheimer-patients
#7
REVIEW
Francisca Magalhães Scoralick, Einstein Francisco Camargos, Marco Polo Dias Freitas, Otávio Toledo Nóbrega
Sleep disorders are common in patients with Alzheimer dementia and affect the quality of life of patients and of their caregivers. Despite the rising number of studies in the area, almost all of them are about non-pharmacological treatment. Our objective was to review the literature concerning pharmacological and non-pharmacological approaches to treat sleep disorders of elderly patients with Alzheimer dementia in the ambulatory setting. The treatments revised consisted of sleep hygiene and/or use of intense light coupled or not with use of melatonin, cholinesterase inhibitors, antipsychotics, hypnotics or antidepressants...
July 2015: Einstein
https://www.readbyqxmd.com/read/25488107/initiation-of-antidepressant-medication-after-hip-fracture-in-community-dwelling-older-adults
#8
Andrea Iaboni, Dallas P Seitz, Hadas D Fischer, Christina C Diong, Paula A Rochon, Alastair J Flint
OBJECTIVE: To evaluate the incidence, characteristics, and correlates of antidepressant drug therapy initiation among community-dwelling older adults following hip fracture. DESIGN: Retrospective cohort study using linked, population-based administrative data. SETTING: Province of Ontario, Canada. PARTICIPANTS: Older adults, aged 65 years or older, with a hip fracture and hip fracture surgery between April 1, 2003, and February 28, 2011...
October 2015: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/25363642/diagnostic-value-of-mibg-cardiac-scintigraphy-for-differential-dementia-diagnosis
#9
Sylvie Slaets, Frank Van Acker, Jan Versijpt, Lothar Hauth, Johan Goeman, Jean-Jacques Martin, Peter Paul De Deyn, Sebastiaan Engelborghs
OBJECTIVE: Iodine-123 metaiodobenzylguanidine (MIBG) cardiac scintigraphy has shown the potential to discriminate dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). However, these studies did not reflect clinical practice, as patients with ischemic heart disease, heart failure, diabetes mellitus, arterial hypertension, and hyperlipidemia and patients treated with antidepressants like trazodone were excluded. METHODS: This study aimed to evaluate the use of MIBG cardiac scintigraphy to diagnose DLB in clinical practice...
August 2015: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/24659320/pharmacotherapies-for-sleep-disturbances-in-alzheimer-s-disease
#10
REVIEW
Jenny McCleery, Daniel A Cohen, Ann L Sharpley
BACKGROUND: Sleep disturbances, including reduced nocturnal sleep time, sleep fragmentation, nocturnal wandering and daytime sleepiness are common clinical problems in dementia due to Alzheimer's disease (AD), and are associated with significant caregiver distress, increased healthcare costs and institutionalisation. Drug treatment is often sought to alleviate these problems, but there is significant uncertainty about the efficacy and adverse effects of the various hypnotic drugs in this vulnerable population...
2014: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/24565367/pharmacological-recommendations-for-the-symptomatic-treatment-of-dementia-the-canadian-consensus-conference-on-the-diagnosis-and-treatment-of-dementia-2012
#11
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
https://www.readbyqxmd.com/read/24164931/pharmacological-treatments-for-frontotemporal-dementias-a-systematic-review-of-randomized-controlled-trials
#12
REVIEW
Maria Nardell, Rajesh R Tampi
The objective of this review is to summarize the current data on the pharmacological treatments for frontotemporal dementias from randomized controlled trials. A systematic search of 4 major databases, PubMed, Medline, PsychINFO and Cochrane, found a total of 9 randomized controlled, double-blinded clinical trials. Of these, 2 trials used the selective serotonin reuptake inhibitor (SSRI), paroxetine; 1 trial used trazodone; 2 trials used stimulants (methylphenidate and dextroamphetamine); 1 trial used the acetylcholinesterase inhibitor, galantamine; 2 trials used the N-methyl-d-aspartate antagonist, memantine; and 1 trial used the neuropeptide oxytocin...
March 2014: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/24108179/-current-treatment-of-depression-and-agitation-in-the-elderly-clinical-use-of-trazodone
#13
REVIEW
Péter Osváth
Due to their increasing frequency, mental disorders among the elderly have special importance in the clinical practice. In this article we summarize the characteristics, diagnostic problems and modern treatments of mental disorders (especially depression) in old age. As this period of life means special somatic and psychic features in people's condition, it may be difficult to find the most effective and well-tolerated treatment, especially in case of comorbid dementia or agitated behaviour. In this article we review the therapeutic experience with the SARI antidepressant trazodone...
September 2013: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/23537795/-delirium-in-nursing-homes-prevalence-and-risk-factors
#14
MULTICENTER STUDY
José Gutiérrez Rodríguez, Marian Rodríguez Piñera, Eloy Ortiz Cachero, Anabel González Alonso, Paloma Pérez Guillén, Francisco Luis Jiménez Muela, Arsenio Alonso Collada, Juan José Solano Jaurrieta
OBJECTIVES: To study the prevalence of delirium in the residential environment and to analyse the associated clinical, functional and mental factors. MATERIAL AND METHODS: A cross-sectional epidemic study was conducted on a population of elderly persons institutionalised in 2011 in 6 nursing homes in Asturias. Socio-demographic, clinical, functional (Barthel Index [BI]) and mental (Mini-Mental State Examination [MMSE]) variables were collected. Delirium was defined by the Confusion Assessment Method...
July 2013: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/23392410/trace-analysis-of-acetylcholinesterase-inhibitors-with-antipsychotic-drugs-for-alzheimer-s-disease-by-capillary-electrophoresis-with-on-column-field-amplified-sample-injection
#15
Yi-Rou Wang, Yuan-Han Yang, Chi-Yu Lu, Shun-Jin Lin, Su-Hwei Chen
A simple and sensitive capillary zone electrophoresis (CZE) with UV detection (214 nm) was developed and validated for the simultaneous determination of the acetylcholinesterase inhibitors (AChEI), donepezil, and rivastigmine, with antipsychotic drugs in plasma. A sample pretreatment by liquid-liquid extraction and subsequent quantification by CZE with field-amplified sample injection (FASI) was used. The optimum separation for these analytes was achieved in <20 min at 25 °C with a fused-silica capillary column of 60...
April 2013: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/23018612/the-use-of-antidepressants-in-belgian-nursing-homes-focus-on-indications-and-dosages-in-the-phebe-study
#16
Jolyce Bourgeois, Monique M Elseviers, Luc Van Bortel, Mirko Petrovic, Robert H Vander Stichele
BACKGROUND: Since antidepressants are prescribed for multiple indications, the use of an antidepressant cannot be equated with a diagnosis of depression. OBJECTIVE: The objective of this study was to examine the quality of antidepressant prescribing in Belgian nursing homes, with a critical evaluation of indications and dosages, to see whether depression was appropriately treated in terms of drug choice, the indications for which antidepressants were being prescribed and whether there was underdosing...
September 2012: Drugs & Aging
https://www.readbyqxmd.com/read/22847063/diagnosis-and-management-of-behavioral-issues-in-frontotemporal-dementia
#17
REVIEW
Masood Manoochehri, Edward D Huey
Frontotemporal lobar degeneration is an umbrella term for several different disorders. In behavioral variant frontotemporal dementia (bvFTD), patients show deterioration in cognition and social behavior. New diagnostic criteria proposed by the International Behavioral Variant FTD Consortium provide greater sensitivity in diagnosing bvFTD. Current pharmacological management of symptoms relies on medications borrowed from treating Alzheimer's disease (AD) and psychiatric disorders. The evidence for using AD medications such as acetylcholinesterase inhibitors is questionable...
October 2012: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/22712761/off-label-uses-of-trazodone-a-review
#18
REVIEW
Letizia Bossini, Ilaria Casolaro, Despoina Koukouna, Federica Cecchini, Andrea Fagiolini
INTRODUCTION: Trazodone is an antidepressant belonging to the class of serotonin receptor antagonists and reuptake inhibitors. It is approved by the FDA for the treatment of depression. Insomnia is the most frequent reason for prescription of trazodone. It has also been proven useful in the treatment of anxiety disorders. Other off-label uses include the treatment of bulimia, benzodiazepine/alcohol dependence, fibromyalgia, central nervous system degenerative diseases (behavioral disorders in dementia and other organic disorders), schizophrenia, chronic pain disease and diabetic neuropathy, sexual dysfunction...
August 2012: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/21629010/a-naturalistic-study-of-trazodone-in-the-treatment-of-behavioral-complications-of-dementia
#19
D J Houlihan, B H Mulsant, R A Sweet, A H Rifai, R Pasternak, J Rosen, G S Zubenko
Altered serotonin transmission has been associated with behavioral complications of degenerative dementia. This study examined whether trazodone, a serotonergic antidepressant, may be useful in treating behavioral syndromes associated with dementia. Twenty-two dementia patients with behavioral problems were treated with trazodone (mean daily dose 172 ± 107 mg; mean duration 20 days). Seventy of cognitive impairment and behavioral symptoms were rated using the Mini-Mental State Examination (MMSE), the Global Assessment Scale, the Hamilton Rating Scale for Depression, and the Brief Psychiatric Rating Scale...
1994: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/21429956/efficacy-and-tolerability-of-antidepressants-in-the-treatment-of-behavioral-and-psychological-symptoms-of-dementia-a-literature-review-of-evidence
#20
REVIEW
Genevieve Henry, Deena Williamson, Rajesh R Tampi
The objective of this review is to summarize the current data on the use of antidepressants in the treatment of behavioral and psychological symptoms of dementia (BPSD) and to determine whether these medications can be recommended for routine clinical use. A literature search of six major databases (PubMed, Medline, PsychINFO, Scopus, Web of Science and Cochrane collaboration) trials, 8 using a selective serotonin reuptake inhibitor (SSRI) compound and 3 using trazodone showed benefit in the treatment of BPSD...
May 2011: American Journal of Alzheimer's Disease and Other Dementias
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