introduction

Treatment of the cause of dementia is only possible in a few cases. Even so, the use of medication can help many patients. They are used to improve the mental performance of the dementia patient and give him the Coping with everyday life to facilitate. Also Behavior disorders can be weakened by medication. In some cases another medication is tried Brain damage to prevent. It should always be noted, however, that in addition to treating dementia with medication, too non-drug Measures are essential.

Therapy decision

There are different Forms of dementiawhich require different therapies. Therefore, before any drugs are treated for dementia, they should be clearly diagnosed and classified.

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Medication for Alzheimer's dementia

Medicines for dementia can make everyday life easier for the patient.

There are currently two drug groups that can improve the typical symptoms of Alzheimer's dementia, such as disorders of the ability to think or impairment of everyday activities Acetylcholinesterase inhibitors and Memantine. It is known that too little in Alzheimer's dementia Acetylcholine present in the brain. The principle of acetylcholinesterase inhibitors is therefore to inhibit the breakdown of acetylcholine so that more of it is in the brain. Typical representatives of this drug group are donepezil, galantamine and rivastigmine. There are indications that starting therapy early can lead to a better course of Alzheimer's dementia; this group of drugs is recommended for mild to moderate stages. The substances are generally well tolerated, frequent Side effects include nausea, vomiting and diarrhea as well as headaches, dizziness and loss of appetite. Often these occur only temporarily and can be alleviated or avoided by taking the medication with food or a gradual dosage. Since there is an increased concentration of glutamate in the brain in Alzheimer's patients, another possibility is the effect of the excess Glutamate to reduce.

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The memantines, which are used in moderate to severe Alzheimer's dementia, work according to this principle. They also improve that Memory function and the Everyday skills. Typical side effects are dizziness, and increased headache sleepiness, but also increased blood pressure and constipation. However, these side effects can be temporary and go away on their own. In severe Alzheimer's dementia, a Combination therapy from a memantine and an acetylcholinesterase inhibitor should be considered, as there is evidence of a better effect. Ginkgo products are also often used to treat Alzheimer's disease. As there is evidence of increased Tendency to clot because of these drugs, the coagulation values ​​in the blood should be checked regularly. The study situation on the effect of these gingko preparations is not uniform. Also the use of other drugs such as vitamin E or non-steroidal anti-inflammatory drugs cannot currently be recommended, as studies have not proven sufficient effectiveness of these groups of substances.

Drugs for vascular dementia

Vascular dementia is a generic term for dementia, which is caused by damage to the Cerebral vessels arise. Therefore, the basis of therapy for this form of dementia is further Vascular damage to prevent. This requires adequate treatment of high blood pressure, sufficient exercise, and giving up Nicotine consumption and possibly weight reduction. Possible drugs to treat vascular dementia, such as Alzheimer's dementia, are acetylcholinesterase inhibitors and memantines. These drugs also improve memory and thinking skills in vascular dementia, although the drugs are less effective than in Alzheimer's disease.

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Frontotemporal dementia

To treat the frontotemporal dementia there are currently no uniform standards. There are studies on active ingredients called galantamine, trazodone and paroxetine, but these were carried out with too few patients to be able to relate the statements made to all those affected.

Lewy body dementia

Also for them Lewy body dementia there is no sufficiently documented and therefore generally recommended drug therapy. However, there are also indications here of the effectiveness of the acetylcholinesterase inhibitor Rivastigmine. This seems to primarily affect the behavioral symptoms of the sick. It should be noted, however, that under this drug therapy there is a deterioration in the Motor skills can come.

Dementia in Parkinson's disease

Parkinson's disease is also often associated with dementia. In the mild to medium stage, those affected can use the acetylcholinesterase inhibitor Rivastigmine be treated. This can improve memory and thinking disorders as well as everyday function. However, here too it should be noted that rivastigmine is a deterioration Motor Parkinson's Symptoms.

Drug therapy for other dementia symptoms

In addition to interference from awareness and perception also often occur in people with dementia Behavior changes on. It is important to always ask whether there is a cause for the change in behavior. So can with dementia patients too Pain or a changed environment lead to a change in behavior. If there is no specific cause or if it is not possible to eliminate it, the drug group of Neuroleptics become necessary. Occur in demented patients depressive moods on, they should be treated with antidepressants. Because of its side effects, it is classified by the drug group of the tricyclic antidepressants advised against. It is not uncommon for people with dementia to be more severe aggressive and agitated Behavior, that is, increased tension. This places a massive burden on the carers in particular. This probably occurs mainly out of fear or when the person with dementia feels that he can no longer make himself understood. A change in the environment or communication often leads to an improvement in the situation. Drug therapy should only be used as a last resort; the neuroleptic risperidone is particularly recommended here. Also common in dementia is the occurrence of delusions and Hallucinations. However, these symptoms can always be one side effect of medication or, for example, as part of a Delirium occur. Therefore, these causes should always be excluded before starting medication. The drug of choice is for delusional and Hallucinations also risperidone. Disturbances of the day-night rhythm and disturbed night sleep also often occur in people with dementia and can put a heavy strain on the environment. However, sleeping pills should be used rarely and only with extreme caution Attention can be used. You can go to a deterioration awareness and memory skills lead and are associated with an increased risk of falling.

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