Advanced Treatment for Dementia
Dementia is a degenerative disease that results in the loss of normal brain function, memory problems, personality and behavior changes, difficulty functioning, and impairment in judgment and thinking. Types of dementia include cortical dementia, subcortical dementia, progressive dementia, primary dementia, secondary dementia, Alzheimer's disease, vascular dementia, Lewy body dementia, frontotemporal dementia, HIV-associated dementia, Huntington's disease, dementia pugilistica, corticobasal degeneration and Creutzfeldt-Jakob disease. As dementia progresses, treatment gets more difficult, but there are a variety of different medications that ameliorate some of the symptoms and improve the patient's quality of life.
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Acetylcholine
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Acetylcholine is an essential neurotransmitter used by the cerebral cortex and hippocampus in the brain and is involved in memory storage. Cholinesterase inhibitors, which prevent the breakdown of acetylcholine, are a common type of medication used for dementia, such as Alzheimer's disease. However, cholinesterase inhibitors do not stop or reverse the progression of Alzheimer's disease or other types of dementia. Examples of cholinesterase inhibitors used for dementia treatment include tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl).
Glutamate
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Another neurotransmitter whose levels are affected by dementia is glutamate. Like acetylcholine, glutamate is also essential for learning and memory. One type of medication used for dementia is memantine, or Namenda, which regulates the level of glutamate. However, combining memantine with a cholinesterase inhibitor produces better results than using memantine alone.
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Anticonvulsants and Antidepressants
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Anticonvulsants and antidepressants are used to treat other problems associated with dementia, such as depression, agitation and seizures. Not all dementia patients will experience these problems and need these medications. However, advanced dementia patients may be more prone to depression, depending on how much they have been limited by their disease. Seizures can also occur more frequently when there is more degeneration to the brain.
Sedatives
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Sedatives can be helpful in treating sleep disorders that may arise from dementia. Sleep problems may also be more common or disruptive as the dementia progresses. However, a doctor should be consulted before starting any sedatives or sleep medications to make sure they do not interfere with other medications.
Atypical Antipsychotics
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Atypical antipsychotics, like olanzapine and risperidone, are used to treat behavioral problems that can arise in dementia. However, the Food and Drug Administration has put out a warning for the elevated risk of death by heart problems or infections in elderly users. If possible, these medications should be avoided in elderly dementia patients, especially if they are at higher risk for heart problems.
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