Antipsychotic Drugs And Dementia Essay

Depression is one of the most recurrently investigated psychological disorders within the area of medical R&D (Montorio & Izal, 1996). A number of exhaustive researches have been carried out to study its symptoms and impacts on different patients belonging to different personal and professional attributes and most of these researchers depicted that depression in the elderly people is very frequent and in spite of number of researches in this context, it is often undiagnosed or untreated. To add to this jeopardy, it has also been estimated that only 10% out of the total depressed elderly individuals receive proper diagnosis and treatment (Holroyd et al, 2000). And for that reason, an authentic

Side-effects such as sedation, falls and extrapyramidal signs are well-known, and more recent work indicates that neuroleptic treatment of dementia leads to reduced well-being and quality of life (Ballard et al, 2001) and may even accelerate cognitive decline (McShane et al, 1997).

     This condition is often harder on the care giver than it is on the persons with Alzheimers. Care givers often find themselves exhausted. The online articles "Sundowning and Sleeping" and "Sundown Syndrome and the Elderly" provide some steps that can be taken to lessen the effects using a coordinated approach by family members and health care providers.

Reckless behavior early in life can affect the rest of your life dramatically. Whether it is drinking too much, use of illegal drugs, or even just a simple vehicle accident, it can cause brain damage which can lead to dementia. Dementia isn’t necessarily a disease but rather terminology to describe a set of symptoms. “Severe impairment in intellectual capacity and personality, often due to damage to the brain” (Gazzaniga, Grison, & Heatherton, 2015). In other words, dementia comes with an inability to process surroundings, a difference in character, and, depending in severity, complete memory loss. This loss is because nerve cells in the parts of the brain that are responsible for cognition, like the cerebellum (Molinari, 2002), have been damaged and can no longer function normally. There are many types of dementia, such as, Alzheimer’s, the most common, as well as many others that differ in symptoms. Though many kinds of dementia normally end in pain, suffering and often death, there is no cure. Dementia is a neurocognitive disorder that can affects one’s life drastically, because of memory loss, an inability to preform everyday activities, and personality changes.

An estimated 47.5 million people suffer from dementia. Every 4 seconds one new case of dementia is diagnosed. Dementia is a term that describes certain symptoms such as impairment to memory, communication and thinking. It is a group of symptoms and not just one illness. Even though one‘s chance of getting dementia increase with age, it is not a part of aging. Dementia is usually diagnosed after a series of assessments that includes a physical evaluation, memory tests, imaging studies and blood work. It affects three aspects of one’s mental function, cognitive dysfunction (Problems with memory, language, thinking and problem solving), psychiatric behavior (changes in personality, emotional control, social behavior and delusions) and difficulties with daily living activities (driving, shopping, eating and dressing). “The median survival time in women is 4.6 years and in men 4.1 years” (Warren, 2016).

Phillips states that individuals with dementia often display resistance to care, confusion, disruptive or aggressive behaviors: For these reasons, many seniors who are not actually suffering from psychosis are given antipsychotic medications. The goal of the pan-Canadian Reducing Antipsychotic Medication in Long Term Care program was to encourage long-term care facilities and nursing homes to discontinue the use of unnecessary antipsychotic medications to experiment with alternative therapies.

Psychotropic medications are approved by the US Food and Drug Administration (FDA) primarily for the treatment of psychosis and mood disturbances associated with schizophrenia or bipolar disorders (Grunier, 2008). Despite FDA black box warnings related to the “off-label” use of these medications in the dementia population, a survey conducted by the Office of Inspector General in 2011 found that 86% to 95% of nursing home residents received these medications for other indications, such as managing behavioral disturbances associated with dementia (Chiu, 2015). It is the overuse and misuse of psychotropic medications, in particular as a strategy to subdue residents, that has designated these drugs to be labeled

Treatment for Dementia requires the patient to be under constant medical care. Most families are responsible for taking care of the patient day to day. Medical focus should be on optimizing the individual’s health and quality of life, while helping the family cope with the many challenges that occur with taking care of the patient. The medical care of the patient also depends on the underlying condition which often consists of medications and non-drug treatments such as behavioral therapy. If the Dementia is related to a hypothyroidism, treatment would be thyroid hormone replacement. Currently there are few medications on the market that have been shown to help, a bit.

Throughout history there have been reports of decreased memory and mental deterioration that accompanied old age. Alzheimer’s disease (AD) was named after Dr. Alois Alzheimer who described the symptoms in a woman in Germany in the 1907 but it was not until the 1970’s that AD was considered to be a major disorder and AD continues to be a major health concern worldwide (Reger, 2002).

As we have seen, treatment of schizophrenia with antipsychotic drugs can have impressive results in terms of decreasing active symptoms, although it does nothing to alleviate negative symptoms or to improve cognitive functioning. Unfortunately, this kind of treatment has the drawback of extremely serious and even fatal side-effects. Newer generation atypical antipsychotics offer more hope, as they can treat both active and negative symptoms, and also improve cognitive functioning. Moreover, they have fewer side-effects. However, treatment is complicated by the fact that results are unpredictable; and in addition the side-effects that they do have can be very serious, such as diabetes, which in itself is life-threatening. However, as the potential side-effects are known, the physician has leeway to choose a drug which is a good match for the patient’s clinical profile. Then, once the patient’s symptoms have been much alleviated with an appropriate newer generation atypical antipsychotic, the patient should be able to also benefit from a range of psychotherapeutic interventions. It is argued that this is the best treatment regime to choose, as it is likely to result in the greatest improvement in quality of life, coupled with the lowest risk of potentially devastating side-effects, or of death. This is likely to be better than utilizing cognitive behavioral therapy, the results of which are not reliably known – although research has certainly shown that it is less efficacious

Traditional antipsychotics are good at reducing the positive symptoms, but do not reduce the negative symptoms and are classified in low-potency and high-potency which can cause many side effects like; dry mouth, tremors, weight gain, muscle tremors, stiffness, motor disturbances, parkinsonian effects, akathisia, dystonia, akinesia, tardive dyskinesia, and neuroleptic malignant syndrome.

Antipsychotic – Psychotropic drugs are often used for neurochemical problems, behavioral problems, schizophrenia, and other mental disorders. These drugs sometimes cause side effects

During my first clinical rotation as a nursing student, I was assigned to care for several older adults suffering from dementia. Although all of my patients ranged in severity from mild to severe progression of dementia, they all experienced moments of agitation, anxiety, or disturbed behaviors related to their disease. It occurred to me after careful review of several patient charts that despite often being prescribed pharmaceutical regimes for other comorbidities, these patients were rarely prescribed medications, besides those to control anxiety, specifically targeted at treating their progressing dementia. Through some research I discovered that the significant number of individuals affected with dementia is a growing public health concern in part due to the current limited ability of pharmaceutical treatments to treat the disease (Samson, Clement, Narme, Schiaratura, & Ehrle, 2015). This revelation began my interest in current nonpharmacological treatments being implemented in controlling adverse behaviors and feelings in patients diagnosed with dementia.

2. The purpose of this study is to evaluate the efficacy and safety of low dose risperidone in treating psychosis of Alzheimer’s disease (AD) and mixed dementia (MD) in a subset of nursing-home residents who had dementia and aggression and who were participating in a randomized placebo-controlled trail of risperidone for aggression.

Typical presenting symptoms in older adults are weakness, insomnia, hypersomnia, headache, fatigue, irritability, chronic constipation, pain, agitation, and unintentional weight loss/change. Dementia and Delirium are also known to have higher rates of depression in older adults. The Geriatric Depression Scale, Cornell Scale for Depression in Dementia, and the nine item Patient Health Questionnaire are screening tools utilized when an older adult presents with signs and symptoms of depression (Downing, Caprio & Lyness, 2013).