Cognitive and Mood Disorders in Parkinson s Disease Video Transcript
|
|
- Karin Benson
- 7 years ago
- Views:
Transcription
1 Cognitive and Mood Disorders in Parkinson s Disease Video Transcript This is the first of two videos describing non-motor symptoms of Parkinson s disease. In this video we discuss cognitive and mood disorders as they relate to Parkinson s disease. Depression is remarkably common in patients with Parkinson s disease and will affect up to 50 percent of patients at some time in their disease. Depression is a strong contributor to reduced quality of life and aggressive treatment can improve this. Symptoms include fatigue, weight gain or weight loss due to an increase or decrease in appetite, sadness, and reduce concentration. The progressive degeneration of different brain systems, especially those affecting the norepinephrine and serotonin systems, combined with the disability associated with Parkinson s disease, are strong contributors to the cause of depression.
2 There are several effective treatments for depression including psychotherapy and medication. Exercise has been shown to improve fatigue and improve mood. So in addition to performing exercise to help motor symptoms, exercise can also help certain nonmotor symptoms. There have been controlled trials of various antidepressants in patients with Parkinson s disease demonstrating significant improvement. These antidepressants include paroxetine, which is an example of a selective serotonin reuptake inhibitor; venlafaxine, which is an example of a serotonin norepinephrine reuptake inhibitor; and nortriptyline, which is a tricyclic antidepressant. Interestingly, the dopamine agonist, pramipexole, has also been shown to improve depression symptoms suffered from its effect on motor symptoms and so may be used to treat both problems. As with depression, anxiety is remarkably common. It may exist by itself or may be seen in combination with depression. Anxiety can be chronic in persistent problems, but it is often worsened in patients with motor fluctuations during the medication-off state when there is worsening of motor symptoms. A variety of medications including
3 benzodiazepines or Valium-type medications in addition to antidepressants may be helpful. Psychotherapy and learning anxiety reduction techniques may also be helpful. Apathy refers to lack of motivation or reduced interest in activity. It is important to determine out whether or not apathy is present by itself or is a symptom of depression. If depression is present, treating the underlying depression may be helpful. Specific treatment paradigms for apathy in Parkinson s disease otherwise have not been fully developed. Behavioral interventions or treatment with stimulants or dopamine agonists might be helpful based on the utility of these treatments in other diseases where apathy is present. Impulse control disorder refers to excessive or inappropriate interest in certain activities. These activities are vegetative or basic drives. The inappropriate interests include pathologic gambling, hypersexuality, excessive interest in certain hobbies, binge eating, compulsive shopping, or internet addiction. Usually, these problems are caused by the use of dopamine agonist medication such as pramipexole, ropinirole, and
4 rotigotine. Often the patient may have poor awareness of the inappropriateness and excessive nature of these activities and the caregiver or spouse may be most aware of these problems. Impulse control disorder may affect up to 17 percent of patients treated with dopamine agonists. Risk factors include being male, being younger in age, being unmarried, and having a personal or family history of drug or alcohol use. Usually, the dopamine agonist dose must be reduced, and often the medication needs to be completely stopped in order to improve these symptoms. A small percentage of patients may have difficulty completely withdrawing from dopamine agonists and this is referred to as dopamine agonist withdrawal syndrome, which can be a chronic problem of drug craving that may not be resolved even with an increase in levodopa dosing. Changes in cognition may be evident even in patients with early mild Parkinson s disease. With increasing age or increasing duration of Parkinson s disease, cognitive impairment may worsen further. The earliest changes seen include slowness of mental processing referred to as bradyphrenia, problems with working memory including storing and processing information, or reduction in executive functioning. This is often most apparent in patients who note difficulty in multi-tasking or doing more than one activity at once. Processing visiospatial information may also be affected relatively early in the disease and aberrant perception of distances associated with this can contribute to bradykinesia or reduced amplitude of movements.
5 Dementia is the greatest source of disability in advanced Parkinson s disease and unfortunately is the most common cause of nursing home placement. Overall, dementia affects about 40 percent of Parkinson s disease patients and risk increases with increasing duration of disease and increased age. The presence of dementia significantly increases mortality. After a duration of 15 years of Parkinson s disease, about 50 percent of patients may become demented and this increases to 80 percent after 20 years of Parkinson s disease. Hallucinations, poor response to levodopa, and increased severity of motor symptoms are associated with dementia. If dementia and parkinsonism occur within one year of each other, this is referred to as dementia with Lewy bodies. On the other hand, if parkinsonism precedes the development of cognitive impairment by several years, the dementia is referred to as Parkinson s disease dementia. For patients who develop dementia, we commonly simplify the anti-parkinson drug regimen, attempting to treat predominantly with levodopa. For its relative anti- Parkinson effect, levodopa is the best tolerated anti-parkinson medication and has less
6 tendency to produce drug-induced psychosis. Modifying the environment and sticking to a routine can be helpful behavioral treatment in dealing with some of the aberrant behaviors that can occur with Parkinson s disease. Rivastigmine has been approved for treatment of dementia associated with Parkinson s disease and another cholinesterase inhibitor, donepezil, has also been shown in smaller clinical trials to be helpful in modestly improving cognition in Parkinson s disease dementia. There is somewhat mixed data on the use of memantine suggesting that this medication might be helpful in some patients with Parkinson s disease dementia also. Treatment of associated behavioral problems such as anxiety, agitation, and hallucinations is also important since these behavioral symptoms may at times be more problematic for the caregiver and patient than cognitive impairment. Psychosis refers to the presence of hallucinations or delusions. Delusions means fixed abnormal thoughts and can often be manifest as paranoia which is an abnormal fear of others trying to do harm to oneself. Patients may also have delusions of infidelity or that others are trying to steal their belongings. Hallucinations in Parkinson s disease patients are typically visual hallucinations where the patient sees people, animals, or things that are unreal. Typically hallucinations may begin as a sense or presence where a patient may briefly see a person or thing in the periphery of vision and this disappears once the patient attends to that area around them. As hallucinations become more severe, the patient may see formed objects or people but retain insight that they are unreal. The hallucinations become quite troublesome when they are persistent and the patient loses insight that the people or things are unreal. Auditory hallucinations and other forms of hallucinations are uncommon in Parkinson s disease. Delusions and hallucinations are typically a manifestation of Parkinson s disease dementia and when they occur in patients who are not yet demented, they are a sign that cortical pathology is accumulating which will result in dementia in the near future. Anti-Parkinson medication worsens hallucinations and delusions. As a result, the medication regimen is typically simplified with levodopa used as a primary treatment and other secondary medications such as anti-cholinergics, amantadine, and then dopamine agonists reduce or dropped if possible. If hallucinations persist despite simplification of the medication regimen or the simplification of the medication regimen results in unacceptable worsening of motor symptoms, then antipsychotics are needed
7 in order to improve these symptoms. Generally, only the atypical antipsychotics quetiapine and clozapine are used since many of the other commonly used antipsychotics substantially worsen motor symptoms of Parkinson s disease.
Dementia & Movement Disorders
Dementia & Movement Disorders A/Prof Michael Davis Geriatrician ACT Health & GSAHS ANU Medical School Eastern Dementia Network Aged and Dementia Care Symposium Bateman s Bay, 22 October 2010 Types of Dementia
More informationASSESSMENT AND MANAGEMENT OF PSYCHOSIS IN PERSONS WITH DEMENTIA
ASSESSMENT AND MANAGEMENT OF PSYCHOSIS IN PERSONS WITH DEMENTIA Overview: Psychosis is a common clinical feature of dementia. Hallucinations and delusions are the two most common types of psychotic symptoms
More informationRecognition and Treatment of Depression in Parkinson s Disease
Recognition and Treatment of Depression in Parkinson s Disease Web Ross VA Pacific Islands Health Care System What is depression? Depression is a serious medical condition that affects a person s feelings,
More informationEmergency Room Treatment of Psychosis
OVERVIEW The term Lewy body dementias (LBD) represents two clinical entities dementia with Lewy bodies (DLB) and Parkinson s disease dementia (PDD). While the temporal sequence of symptoms is different
More informationDepression in Older Persons
Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression
More informationDepression in the Elderly: Recognition, Diagnosis, and Treatment
Depression in the Elderly: Recognition, Diagnosis, and Treatment LOUIS A. CANCELLARO, PhD, MD, EFAC Psych Professor Emeritus and Interim Chair ETSU Department of Psychiatry & Behavioral Sciences Diagnosis
More informationClinical Audit: Prescribing antipsychotic medication for people with dementia
Clinical Audit: Prescribing antipsychotic medication for people with dementia Trust, team and patient information Q1. Patient's DIS number... Q2. Patient s residence: Home Residential Home Nursing Home
More informationHow To Treat Aphasic Depression
Antipsychotic Use in Patients with Parkinson s Disease 단국의대 정신과 이석범 Difficulties in Parkinson's disease Motor symptoms Neuropsychiatric syndromes Severe Disability Cognitive impairment 2 Neuropsychiatric
More informationAn Introduction to Lewy Body Dementia
An Introduction to Lewy Body Dementia A special publication for people newly diagnosed with Lewy body dementia and those still seeking answers. You don t have to face LBD alone. Increasing Knowledge Sharing
More informationDepression is a common biological brain disorder and occurs in 7-12% of all individuals over
Depression is a common biological brain disorder and occurs in 7-12% of all individuals over the age of 65. Specific groups have a much higher rate of depression including the seriously medically ill (20-40%),
More informationParkinson s Disease - A Junior Doctor s Survival Guide
Parkinson s Disease - A Junior Doctor s Survival Guide Professor Richard Walker Consultant Geriatrician Hon. Professor of Ageing & Interna
More informationOverview of Mental Health Medication Trends
America s State of Mind Report is a Medco Health Solutions, Inc. analysis examining trends in the utilization of mental health related medications among the insured population. The research reviewed prescription
More informationUpdate on Treatment of the Dementias
Update on Treatment of the Dementias Mark Pippenger, MD Behavioral Neurology Associate Clinical Professor of Neurology University of Arkansas for Medical Sciences Disclosures I will be discussing off-label
More informationClinical Research in Parkinson s Disease: The Advances, Challenges, and Importance of Rater Training
Clinical Research in Parkinson s Disease: The Advances, Challenges, and Importance of Rater Training Marian A. Ormont, MD epharmasolutions, A WIRB-Copernicus Group Company April is Parkinson s disease
More informationCENTRAL NERVOUS SYSTEM MANAGEMENT OF PARKINSON S DISEASE
MANAGEMENT CENTRAL NERVOUS SYSTEM MANAGEMENT OF PARKINSON S DISEASE Parkinson s Disease is classically determined by the triad or rest tremor (usually starting in one arm) with bradykinesia (slowing of
More informationDepression and Anxiety in Parkinson s disease
Depression and Anxiety in Parkinson s disease Greg Pontone, MD Director, Movement Disorders Psychiatry Clinical Programs at Johns Hopkins Morris K. Udall Parkinson's Disease Research Center Johns Hopkins
More informationDepression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.
The Family Library DEPRESSION What is depression? Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too. Also called
More informationDepression Flow Chart
Depression Flow Chart SCREEN FOR DEPRESSION ANNUALLY Assess for depression annually with the PHQ-9. Maintain a high index of suspicion in high risk older adults. Consider suicide risk and contributing
More informationParkinson s Disease: General Information
Parkinson s Disease: General Information Does PD come in stages? If so, how many stages? Hubert Fernandez, MD: Staging provides an artificial classification of a patient's illness severity but, in reality,
More informationAntipsychotic drug prescription for patients with dementia in long-term care. A practice guideline for physicians and caregivers
SUPPLEMENT 1: (Supplementary Material for online publication) Antipsychotic drug prescription for patients with dementia in long-term care. A practice guideline for physicians and caregivers About this
More informationDementa Formulary Guidance [v1.0]
Dementa Formulary Guidance [v1.0] 1. Introduction These Guidelines are intended for routine use. However there will be instances where they are not suitable for the patient you are managing, where more
More informationChapter 18 Drugs Used for Psychoses Learning Objectives Identify signs and symptoms of psychotic behavior Describe major indications for the use of
Chapter 18 Drugs Used for Psychoses Learning Objectives Identify signs and symptoms of psychotic behavior Describe major indications for the use of antipsychotic agents Identify common adverse effects
More informationThese guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes.
This is a new guideline. These guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes. It incorporates NICE clinical
More informationConjoint Professor Brian Draper
Chronic Serious Mental Illness and Dementia Optimising Quality Care Psychiatry Conjoint Professor Brian Draper Academic Dept. for Old Age Psychiatry, Prince of Wales Hospital, Randwick Cognitive Course
More informationSummary of the risk management plan (RMP) for Rasagiline ratiopharm (rasagiline)
EMA/744222/2014 Summary of the risk management plan (RMP) for Rasagiline ratiopharm (rasagiline) This is a summary of the risk management plan (RMP) for Rasagiline ratiopharm, which details the measures
More informationGUIDELINES FOR USE OF PSYCHOTHERAPEUTIC MEDICATIONS IN OLDER ADULTS
GUIDELINES GUIDELINES FOR USE OF PSYCHOTHERAPEUTIC MEDICATIONS IN OLDER ADULTS Preamble The American Society of Consultant Pharmacists has developed these guidelines for use of psychotherapeutic medications
More informationA Depression Education Toolkit
A Depression Education Toolkit Facts about Depression in Older Adults What is Depression? Depression is a medical illness. When sadness persists or interferes with everyday life, it may be depression.
More informationLong Term Care Formulary HCD - 09. Anti-Dementia Drugs (e.g. donepezil, galantamine, rivastigmine, memantine)
1 of 8 USE OF CHOLINESTERASE (AChE) INHIBITORS The cholinesterase inhibitor anti-dementia drugs are indicated for the symptomatic treatment of patients with mild to moderate dementia of the Alzheimer s
More informationPrimary Care Update January 28 & 29, 2016 Alzheimer s Disease and Mild Cognitive Impairment
Primary Care Update January 28 & 29, 2016 Alzheimer s Disease and Mild Cognitive Impairment Kinga Szigeti, MD Associate Professor UBMD Neurology UB Department of Neurology Questions How do we differentiate
More informationLewy body dementia Referral for a Diagnosis
THE Lewy Body society The more people who know, the fewer people who suffer Lewy body dementia Referral for a Diagnosis Lewy Body Dementias REFERRAL FOR A DIAGNOSIS In the UK people with all forms of dementia
More informationAlzheimer's: The Latest Assessment and Treatment Strategies
Questions from chapter 1 Alzheimer's: The Latest Assessment and Treatment Strategies 1) What is a loss of cognitive and intellectual powers without changes in consciousness. a) dementia b) delusions c)
More informationLecture Objectives/ Goals
Lewy Body Dementia: Challenges and Treatment Karen Mullins, D.O. Knoxville Neurology Clinic Lecture Objectives/ Goals Be familiar with signs and symptoms of the pt with LBD Review pathophysiology of LBD
More informationAmphetamines Addiction
Introduction Amphetamines, which are classified as stimulants, work by using the dopamine reward system of the brain. When these drugs are used, the user s central nervous system is simulated which causes
More informationMajor Depression. What is major depression?
Major Depression What is major depression? Major depression is a serious medical illness affecting 9.9 million American adults, or approximately 5 percent of the adult population in a given year. Unlike
More informationSee also www.thiswayup.org.au/clinic for an online treatment course.
Depression What is depression? Depression is one of the common human emotional states. It is common to experience feelings of sadness and tiredness in response to life events, such as losses or disappointments.
More informationDonepezil hydrochloride (Aricept) Drug treatment for Alzheimer s disease
IS 11 October 2011 Information sheet Donepezil hydrochloride (Aricept) Drug treatment for Alzheimer s disease Introduction... 1 How does Aricept work?... 1 Who might benefit from Aricept?... 2 What effect
More informationIMR ISSUES, DECISIONS AND RATIONALES The Final Determination was based on decisions for the disputed items/services set forth below:
Case Number: CM13-0018009 Date Assigned: 10/11/2013 Date of Injury: 06/11/2004 Decision Date: 01/13/2014 UR Denial Date: 08/16/2013 Priority: Standard Application Received: 08/29/2013 HOW THE IMR FINAL
More informationMedication Glossary Drug Classes and Medications
Understanding Lewy Body Dementia Lewy body dementia (LBD) is a brain disorder that impairs thinking, movement, sleep and behavior. It also affects autonomic body functions, such as blood pressure control,
More informationBehavioral Health Best Practice Documentation
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
More informationDepre r s e sio i n o i n i a dults Yousuf Al Farsi
Depression in adults Yousuf Al Farsi Objectives 1. Aetiology 2. Classification 3. Major depression 4. Screening 5. Differential diagnosis 6. Treatment approach 7. When to refer 8. Complication 9. Prognosis
More informationDEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE
1 DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE ASSESSMENT/PROBLEM RECOGNITION 1. Did the staff and physician seek and document risk factors for depression and any history of depression? 2. Did staff
More informationPatients with dementia and other types of structural brain injury are predisposed to delirium (i.e., abrupt onset, temporary confusion caused by
Dementia is the permanent loss of multiple intellectual functions resulting from neuronal death. Dementia afflicts 10% of individuals over the age of 65 and these patients survive approximately seven years
More informationDepression: What You Need to Know
Depression: What You Need to Know What is a Depressive Illness? A depressive illness is a whole-body illness, involving your body, mood, thoughts, and behavior. It affects the way you eat and sleep, the
More informationPharmacotherapy of BPSD. Pharmacological interventions. Anti-dementia drugs. Abhilash K. Desai MD Medical Director Alzheimer s Center of Excellence
Pharmacotherapy of BPSD Abhilash K. Desai MD Medical Director Alzheimer s Center of Excellence Pharmacological interventions Reducing medication errors. Reducing potentially inappropriate medication prescription.
More informationSexual Behavior in Dementia
Sexual Behavior in Dementia Paul Mulhausen, MD 2014 Disclosure I have no conflict of interest to report None of the medication treatments discussed in this presentation have an FDA-approved indication
More informationSchizoaffective Disorder
FACT SHEET 10 What Is? Schizoaffective disorder is a psychiatric disorder that affects about 0.5 percent of the population (one person in every two hundred). Similar to schizophrenia, this disorder is
More informationBRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS
BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems
More informationParkinson's s disease - a
Parkinson's Disease Parkinson's s disease - a progressive disorder of the nervous system that affects movement. The most common perception of Parkinson s is the patient having tremors. Hands shaking, inability
More informationTREATING MAJOR DEPRESSIVE DISORDER
TREATING MAJOR DEPRESSIVE DISORDER A Quick Reference Guide Based on Practice Guideline for the Treatment of Patients With Major Depressive Disorder, Second Edition, originally published in April 2000.
More informationPARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS
PARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS De Anna Looper, RN CHPN Corporate Clinical Consultant / Legal Nurse Consultant Carrefour Associates L.L.C. PARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS
More informationDrugs PSYCHOSIS. Depression. Stress Medical Illness. Mania. Schizophrenia
Drugs Stress Medical Illness PSYCHOSIS Depression Schizophrenia Mania Disorders In preschool children imaginary friends and belief in monsters under the bed is normal (it may be normal in older developmentally
More informationABC s of Parkinson s Disease 4/29/15 Karen Parenti, MS, PsyD
ABC s of Parkinson s Disease 4/29/15 Karen Parenti, MS, PsyD What is Parkinson s Disease? Parkinson's disease is a progressive disorder of the nervous system that affects movement. It develops gradually,
More informationNICE Clinical guideline 23
NICE Clinical guideline 23 Depression Management of depression in primary and secondary care Consultation on amendments to recommendations concerning venlafaxine On 31 May 2006 the MHRA issued revised
More informationSUBSTANCE ABUSE & DEPRESSION: WHAT YOU SHOULD KNOW
SUBSTANCE ABUSE & DEPRESSION: WHAT YOU SHOULD KNOW TABLE OF CONTENTS What is Depression? 4 Symptoms of Depression 6 Substance Abuse as a Coping Mechanism 8 Which Occurs First? 10 Substance Abuse and the
More informationAMPHETAMINE AND COCAINE MECHANISMS AND HAZARDS
AMPHETAMINE AND COCAINE MECHANISMS AND HAZARDS BARRY J. EVERITT Department of Experimental Psychology, University of Cambridge Stimulant drugs, such as cocaine and amphetamine, interact directly with dopamine
More informationPARKINSON S DISEASE AND PARKINSONISM. Dr Phil Wood Geriatrician, Waitemata DHB Clinical Unit Leader, Waikato DHB
PARKINSON S DISEASE AND PARKINSONISM Dr Phil Wood Geriatrician, Waitemata DHB Clinical Unit Leader, Waikato DHB OUTLINE Covering:- Why this is an important area of Medical and Psychiatric care The variety
More informationPRESCRIPTION DRUG ABUSE prevention
PRESCRIPTION DRUG ABUSE prevention Understanding Drug Addiction Many people do not understand how someone could abuse drugs even when their life seems to be falling apart. It is often assumed that those
More informationDelusions are false beliefs that are not part of their real-life. The person keeps on believing his delusions even when other people prove that the be
Schizophrenia Schizophrenia is a chronic, severe, and disabling brain disorder which affects the whole person s day-to-day actions, for example, thinking, feeling and behavior. It usually starts between
More informationPsychotic Disorder. Psychosis. Psychoses may be caused by: Examples of Hallucinations and Delusions 12/12/2012
Psychosis Psychotic Disorder Dr Lim Boon Leng Psychiatrist and Medical Director Dr BL Lim Centre For Psychological Wellness Tel: 64796456 Email: info@psywellness.com.sg Web: www.psywellness.com.sg A condition
More informationAlcohol Withdrawal Syndrome & CIWA Assessment
Alcohol Withdrawal Syndrome & CIWA Assessment Alcohol Withdrawal Syndrome is a set of symptoms that can occur when an individual reduces or stops alcoholic consumption after long periods of use. Prolonged
More informationMAJOR DEPRESSION DURING CONCEPTION AND PREGNANCY: A Guide for Patients and Families
MAJOR DEPRESSION DURING CONCEPTION AND PREGNANCY: A Guide for Patients and Families David A. Kahn, MD, Margaret L. Moline, PhD, Ruth W. Ross, MA, Lee S. Cohen, MD, and Lori L. Altshuler, MD www.womensmentalhealth.org
More informationParkinson s Disease and Dementia. Dr N Samaniego Consultant Physician and Geriatrician
Parkinson s Disease and Dementia Dr N Samaniego Consultant Physician and Geriatrician Case 68 year old female. Off legs for a few months, O/E no neurological deficit. -Slowing down -Needs help with dressing,
More informationadaptations whenever possible, to prevent or reduce the occurrence of challenging behaviours.
POSITION STATEMENT on Management of Challenging Behaviours in People with Dementia 1. AIM OF THE POSITION STATEMENT This position statement applies to people living in supported accommodation and those
More informationUpdate on guidelines on biological treatment of depressive disorder. Dr. Henry CHEUNG Psychiatrist in private practice
Update on guidelines on biological treatment of depressive disorder Dr. Henry CHEUNG Psychiatrist in private practice 2013 update International Task Force of World Federation of Societies of Biological
More informationJ/601/2874. This unit must be assessed in accordance with Skills for Care and Development s QCF Assessment Principles.
Unit 13: Dementia Awareness Unit code: DEM 201 Unit reference number: J/601/2874 QCF level: 2 Credit value: 2 Guided learning hours: 17 Unit summary The aim of the unit is to enable learners to gain knowledge
More informationMemantine (Ebixa) Drug treatment for Alzheimer s disease
IS 20 October 2011 Information sheet Memantine (Ebixa) Drug treatment for Alzheimer s disease Introduction... 1 How does Ebixa work?... 1 Who might benefit?... 2 What effect might Ebixa have?... 2 How
More informationCLINICIAN INTERVIEW COMPLEXITIES OF BIPOLAR DISORDER. Interview with Charles B. Nemeroff, MD, PhD
COMPLEXITIES OF BIPOLAR DISORDER Interview with Charles B. Nemeroff, MD, PhD Dr Nemeroff is the Reunette W. Harris Professor and Chairman of the Department of Psychiatry and Behavioral Sciences at Emory
More informationMedications for Huntington s Disease Vicki Wheelock, M.D.
Medications for Huntington s Disease Vicki Wheelock, M.D. Director, HDSA Center of Excellence at UC Davis June 4, 2013 Outline Introduction and disclaimers Medications for cognitive symptoms Medications
More informationChapter 28. Drug Treatment of Parkinson s Disease
Chapter 28 Drug Treatment of Parkinson s Disease 1. Introduction Parkinsonism Tremors hands and head develop involuntary movements when at rest; pin rolling sign (finger and thumb) Muscle rigidity arthritis
More informationThe Road to Rehabilitation, Part 6: Mapping the Way: Drug Therapy & Brain Injury Written by Gregory O Shanick, MD
The Road to Rehabilitation, Part 6: Mapping the Way: Drug Therapy & Brain Injury Written by Gregory O Shanick, MD Introduction The basic unit of the nervous system is the neuron or nerve cell. Billions
More informationCholinesterase inhibitors and memantine use for Alzheimer s disease TOPIC REVIEW
Cholinesterase inhibitors and memantine use for Alzheimer s disease TOPIC REVIEW Diagnosis of Dementia : DSM-IV criteria Loss of memory and one or more other cognitive abilities Aphasia Apraxia Agnosia
More informationUnderstanding Antipsychotic Medications
Understanding Antipsychotic Medications NARSAD RESEARCH National Alliance for Research on Schizophrenia and Depression 60 Cutter Mill Road, Suite 404 Great Neck, NY 11021 516-829-0091 1-800-829-8289 516-487-6930
More informationDEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource
E-Resource March, 2015 DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource Depression affects approximately 20% of the general population
More informationManagement of Parkinson s Disease in Primary Care
Management of Parkinson s Disease in Primary Care Dr June Tan National University Hospital System (NUHS) Division of Neurology Senior Consultant Topics: Diagnosing PD Choice of medication in the de novo
More informationParkinson Disease Levodopa-Induced Dyskinesia. Christopher Kenney, MD Novartis Pharmaceuticals
Parkinson Disease Levodopa-Induced Dyskinesia Christopher Kenney, MD Novartis Pharmaceuticals Disclosures Dr. Kenney is a full-time employee of Novartis Pharmaceuticals Corporation The opinions expressed
More informationMental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
More informationMOH CLINICAL PRACTICE GUIDELINES 6/2011 DEPRESSION
MOH CLINICAL PRACTICE GUIDELINES 6/2011 DEPRESSION Executive summary of recommendations Details of recommendations can be found in the main text at the pages indicated. Clinical evaluation D The basic
More informationComorbid Conditions in Autism Spectrum Illness. David Ermer MD June 13, 2014
Comorbid Conditions in Autism Spectrum Illness David Ermer MD June 13, 2014 Overview Diagnosing comorbidities in autism spectrum illnesses Treatment issues specific to autism spectrum illnesses Treatment
More informationObjectives. Aging and Forgetfulness Define Dementia Types of Dementia Treatment
Dementia David Lam, MD, FRCPC, Psychiatry Assistant Clinical Professor Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton, Ontario Objectives Aging and Forgetfulness Define
More informationBipolar Disorder. When people with bipolar disorder feel very happy and "up," they are also much more active than usual. This is called mania.
Bipolar Disorder Introduction Bipolar disorder is a serious mental disorder. People who have bipolar disorder feel very happy and energized some days, and very sad and depressed on other days. Abnormal
More informationAntipsychotics in people with dementia an update and reminder
www.bpac.org.nz keyword: dementia Antipsychotics in people with dementia an update and reminder Key concepts: Non-pharmacological treatments for the behavioural and psychological symptoms of dementia (BPSD)
More informationIdentifying and Treating Dual-Diagnosed Substance Use and Mental Health Disorders. Presented by: Carrie Terrill, LCDC
Identifying and Treating Dual-Diagnosed Substance Use and Mental Health Disorders Presented by: Carrie Terrill, LCDC Overview What is Dual Diagnosis? How Common is Dual Diagnosis? What are Substance Use
More informationTreating Depression to Remission in the Primary Care Setting. James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health
Treating Depression to Remission in the Primary Care Setting James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health 2007 United Behavioral Health 1 2007 United Behavioral Health Goals
More informationNorth Bay Regional Health Centre
Addictions and Mental Health Division Programs Central Intake Referral Form The Central Intake Referral Form is used in the District of Nipissing by the North Bay Regional Health Centre s Addictions and
More informationNeuropsychiatry Disorders
Neuropsychiatry Disorders Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems (Copyright UHS 2009; All rights reserved) For more information: Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems 12710
More informationDepression in Older Adults A Guide for Patients and Families
The Expert Consensus Guideline Series Depression in Older Adults A Guide for Patients and Families Reprinted from: Alexopoulos GS, Katz IR, Reynolds CF III, Carpenter D, and Docherty JP. The Expert Consensus
More informationThis document presents the recommendations of an
SPECIAL ARTICLES Consensus Statement on Improving the Quality of Mental Health Care in U.S. Nursing Homes: Management of Depression and Behavioral Symptoms Associated with Dementia American Geriatrics
More informationDepression & Multiple Sclerosis
Depression & Multiple Sclerosis Managing specific issues Aaron, diagnosed in 1995. The words depressed and depression are used so casually in everyday conversation that their meaning has become murky.
More informationMental health problems in people with MS: What can we do? Eli Silber Consultant Neurologist Kings College hospital
Mental health problems in people with MS: What can we do? Eli Silber Consultant Neurologist Kings College hospital The emotional consequences of MS MS Population General Population Depression (Lifetime
More informationRonald Postuma, Christos Galatas. A Guide to the Non-Motor Symptoms. Parkinson s Disease. A patient-friendly booklet for:
Ronald Postuma, Christos Galatas A Guide to the Non-Motor Symptoms of Parkinson s Disease A patient-friendly booklet for: This booklet is to help you understand Parkinson s Disease and prepare for the
More informationUnderstanding Parkinson s Disease
Understanding Parkinson s Disease Irene Oh, MD Neurologist, Movement Disorders Specialist The Neurology Center of Southern California, Encinitas & Escondido Introduction PD was first described in 1817
More informationDepression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City
Depression and its Treatment in Older Adults Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City What is Depression? Everyday use of the word Clinically significant depressive symptoms : more severe,
More informationSummary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole)
EMA/303592/2015 Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole) This is a summary of the risk management plan (RMP) for Aripiprazole Pharmathen, which details the measures
More informationMore than just feelings of unhappiness, clinical or major depression is a mood disorder a medical illness that involves both the body and mind.
What is depression? More than just feelings of unhappiness, clinical or major depression is a mood disorder a medical illness that involves both the body and mind. 1,2 The difference between clinical depression
More informationTreatments for Major Depression. Drug Treatments The two (2) classes of drugs that are typical antidepressants are:
Treatments for Major Depression Drug Treatments The two (2) classes of drugs that are typical antidepressants are: 1. 2. These 2 classes of drugs increase the amount of monoamine neurotransmitters through
More informationDepression Signs & Symptoms
Depression Signs & Symptoms Contents What Is Depression? What Are The Signs And Symptoms Of Depression? How Do The Signs And Symptoms Of Depression Differ In Different Groups? What Are The Different Types
More informationThe Urge to React : Obsessive Compulsive Disorder and Huntington s Disease. John Barkenbus, MD North Carolina Neuropsychiatry Charlotte Clinic
The Urge to React : Obsessive Compulsive Disorder and Huntington s Disease John Barkenbus, MD North Carolina Neuropsychiatry Charlotte Clinic Disclaimer The information provided by speakers in workshops,
More informationCorporate Presentation May 13, 2015
Corporate Presentation May 13, 2015 Creating the Next Generation of CNS Drugs Forward-Looking Statement This presentation contains forward-looking statements. These statements relate to future events and
More informationProgression MIDDLE STAGE. What is Alzheimer s disease?
Progression MIDDLE STAGE This document is one in a five-part series on the stages of Alzheimer s disease and is written for the person with the disease, their family and caregivers. The middle stage of
More informationDoncaster & Bassetlaw Medicines Formulary
Doncaster & Bassetlaw Medicines Formulary Section 4.9: Drugs Used in Parkinsonism and related Disorders Co-Beneldopa 12.5/50, 25/100 and 50/200 (Madopar) Capsules Co-Beneldopa 12.5/50 and 25/100 Dispersible
More information