memantine agitation | Page 2

Torsten Kratz
BACKGROUND: Behavioral disorders such as aggressiveness, agitation, delusions, disinhibition, affect lability, and apathy arise in more than 90% of patients with dementia. Behavioral disorders are a major challenge and the greatest stress factor in everyday life for nursing personnel and for family members caring for the patient. METHODS: This review is based on relevant publications retrieved by a selective literature search in the PubMed, Cochrane Library, and German S3 guideline databases with the search terms "behavioral disorders," "non-cognitive disorders," and "challenging behavior," in conjunction with "dementia" and "behavioral and psychological symptoms of dementia...
June 30, 2017: Deutsches Ärzteblatt International
Anton P Porsteinsson, Inga M Antonsdottir
Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are associated with significant negative outcomes for patients and their caregivers. Agitation, one of the most distressing NPS, lacks safe and effective long term interventions. Nonpharmacological interventions are suggested as first-line treatment, but aren't effective for every patient, resulting in pharmacological interventions for some patients, consisting of off-label use of antipsychotics, sedative/hypnotics, anxiolytics, acetylcholinesterase inhibitors, memantine, and antidepressants; where efficacy doesn't necessarily outweigh associated risks...
April 2017: Expert Opinion on Pharmacotherapy
John T O'Brien, Clive Holmes, Matthew Jones, Roy Jones, Gill Livingston, Ian McKeith, Peter Mittler, Peter Passmore, Craig Ritchie, Louise Robinson, Elizabeth L Sampson, John-Paul Taylor, Alan Thomas, Alistair Burns
The British Association for Psychopharmacology coordinated a meeting of experts to review and revise its previous 2011 guidelines for clinical practice with anti-dementia drugs. As before, levels of evidence were rated using accepted standards which were then translated into grades of recommendation A-D, with A having the strongest evidence base (from randomised controlled trials) and D the weakest (case studies or expert opinion). Current clinical diagnostic criteria for dementia have sufficient accuracy to be applied in clinical practice (B) and both structural (computed tomography and magnetic resonance imaging) and functional (positron emission tomography and single photon emission computerised tomography) brain imaging can improve diagnostic accuracy in particular situations (B)...
February 2017: Journal of Psychopharmacology
Pan Li, Wei Quan, Yu-Ying Zhou, Yan Wang, Hui-Hong Zhang, Shuai Liu
Previous studies have focused on the curative effects of memantine in patients with mild-to-moderate frontotemporal lobar degeneration (FTLD); however, its benefits in patients with moderate-to-severe FTLD have not been investigated. The present study explores the behavioral, cognitive and functional effects of memantine on behavioral variant frontotemporal dementia (bvFTD) in patients with mild and moderate-to-severe stage bvFTD. A total of 42 patients with bvFTD completed a 6-month treatment plan of 20 mg memantine daily in an open-label, self-controlled clinical trial...
July 2016: Experimental and Therapeutic Medicine
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...
March 2017: Geriatrics & Gerontology International
Inga M Antonsdottir, Jessica Smith, Melanie Keltz, Anton P Porsteinsson
INTRODUCTION: Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are associated with significant negative outcomes for patients and their caregivers. Agitation, one of the most distressing NPS, lacks well-established long-term interventions that are both effective and safe. While non-pharmacological interventions are the suggested first-line treatment, it isn't effective in managing symptoms for every patient. In such cases, clinicians turn to the use of pharmacological interventions...
2015: Expert Opinion on Pharmacotherapy
Nan Zhang, Changjuan Wei, Hongjian Du, Fu-Dong Shi, Yan Cheng
BACKGROUND/AIMS: Memantine has been approved by the Food and Drug Administration for the treatment of moderate-to-severe Alzheimer's disease (AD). However, the effect of memantine on patients with mild-to-moderate AD is unclear. METHODS: This study is a post hoc analysis of a double-blind clinical trial. Donepezil was used as the standard control treatment. Outcomes included score changes from baseline to week 24 on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), a modified 20-item Activities of Daily Living Scale (ADL), the Neuropsychiatric Inventory (NPI), and the Mini-Mental State Examination (MMSE) as well as the score of the Clinician's Interview-Based Impression of Change plus Caregiver Input (CIBIC-Plus)...
2015: Dementia and Geriatric Cognitive Disorders
Shinji Matsunaga, Taro Kishi, Nakao Iwata
BACKGROUND: We performed an updated meta-analysis of randomized placebo-controlled trials testing memantine monotherapy for patients with Alzheimer's disease (AD). METHODS: The meta-analysis included randomized controlled trials of memantine monotherapy for AD, omitting those in which patients were also administered a cholinesterase inhibitor. Cognitive function, activities of daily living, behavioral disturbances, global function, stage of dementia, drug discontinuation rate, and individual side effects were compared between memantine monotherapy and placebo groups...
2015: PloS One
Clive Ballard, Alan Thomas, Stephen Gerry, Ly-Mee Yu, Dag Aarsland, Claire Merritt, Anne Corbett, Christopher Davison, Narenda Sharma, Zunera Khan, Byron Creese, Paul Loughlin, Carol Bannister, Alistair Burns, Soe Nyunt Win, Zuzana Walker
BACKGROUND: Neuropsychiatric symptoms in Alzheimer disease (AD) cause significant distress and present a complex clinical challenge for treatment. Pharmacological treatment options are limited to antipsychotics, which carry extensive safety issues. There is emerging evidence to support the potential benefits of memantine, currently licensed for moderate to severe AD, in the prophylaxis of neuropsychiatric symptoms. METHODS: The MAIN-AD study is a double-blind randomized placebo-controlled withdrawal trial comparing memantine with antipsychotics for the treatment of neuropsychiatric symptoms over 24 weeks...
April 2015: Journal of the American Medical Directors Association
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
Fulvio Da Re, Francesco Rucci, Valeria Isella
The authors retrospectively reviewed the clinical records of 196 patients with dementia treated with memantine for at least 6 months. Eleven (5.6%) developed treatment-induced agitation. At chi-square analysis, they were significantly more likely to have a history of similar side effects from other medications acting on the central nervous system in comparison with the group without agitation, suggesting neurochemical susceptibility. A trend toward a significantly greater prevalence was also present for ischemic cardiopathy and neuroimaging evidence of chronic small vessel disease...
2015: Journal of Neuropsychiatry and Clinical Neurosciences
Stephen L Thornton, Richard F Clark
Donepezil and memantine are commonly prescribed antidementia drugs. There is a paucity of literature concerning pediatric ingestions of these drugs. We describe a case of a 2-year-old child who developed encephalopathy after an unintentional ingestion of donepezil and memantine. A 2-year-old girl was found by her family members agitated and reporting visual hallucinations. In the emergency department, she became sedated and had rightward eye deviation. She was hospitalized and had extensive neurological and infectious disease testing that was unremarkable, except for an electroencephalogram, which showed a nonspecific encephalopathy...
September 2014: Pediatric Emergency Care
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
Yuliya E Borre, Theodora Panagaki, Pim J Koelink, Mary E Morgan, Hendrikus Hendriksen, Johan Garssen, Aletta D Kraneveld, Berend Olivier, Ronald S Oosting
Rising neurodegenerative and depressive disease prevalence combined with the lack of effective pharmaceutical treatments and dangerous side effects, has created an urgent need for the development of effective therapies. Considering that these disorders are multifactorial in origin, treatments designed to interfere at different mechanistic levels may be more effective than the traditional single-targeted pharmacological concepts. To that end, an experimental diet composed of zinc, melatonin, curcumin, piperine, eicosapentaenoic acid (EPA, 20:5, n-3), docosahexaenoic acid (DHA, 22:6, n-3), uridine, and choline was formulated...
April 2014: Neuropharmacology
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
D Kontis, I Theochari, E Tsalta
Dementia and bipolar disorder have been traditionally considered two separate clinical entities. However, recent preclinical and clinical data in elderly people suggest that they are in fact related. Several theories have been put forward to interpret their relationship which could be summed up as follows: (1) Dementia could increase the risk for the emergence of bipolar symptoms, or (2) conversely, bipolar disorder might be associated with heightened risk for developing pseudodementia or dementia. (3) Alternatively, dementia, other brain diseases or drugs affecting brain function could lead to the combination of symptoms of dementia and bipolar disorder in elderly individuals...
April 2013: Psychiatrikē, Psychiatriki
Hidenobu Suzuki, Yuichi Inoue, Akiyoshi Nishiyama, Katsunaka Mikami, Keishi Gen
OBJECTIVE: We investigated the clinical efficacy and changes in the dosages of concomitantly used psychotropic drugs in memantine therapy in Alzheimer's disease (AD) with behavioral and psychological symptoms on dementia (BPSD). METHODS: The subjects were 38 inpatients who had been diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). The outcome measures assessed were BPSD and cognitive function. BPSD was assessed using the neuropsychiatric inventory (NPI) and cognitive function was assessed using the mini-mental examination (MMSE)...
June 2013: Therapeutic Advances in Psychopharmacology
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
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