The tactics of drug therapy for dementia

Dementia - a syndrome manifested by a variety of disorders in the areas of the psyche: cognitive( the area of ​​cognitive processes) and mnestical( imprinting department, preservation and reproduction of information).The disease is often accompanied by emotional and affective disorders and personality changes with a conserved level of consciousness. After determining and confirming the diagnosis and clarifying the etiological cause of the pathology, the patient's tactics of management and the scheme of using pharmacological drugs for the treatment of dementia are selected on an individual basis.

Principles of treatment of

The main task for drawing up an adequate program and selecting the most suitable drugs for dementia is to determine the exact diagnosis. However, quite often in clinical practice, there arises a difficult problem of differential diagnosis of dementia with manifestations of natural biological aging and states like delirium and depression. Therefore, a fundamental principle for the selection of drugs in dementia advocates the use of not only the screening scales, but also more informative neuropsychological tests that determine the symptoms and signs of dementia.

Tactics medical treatment of dementia represented program component:

• tablets factors leading to dementia;
• means to overcome emotional disorders and affective disorders.

Treatment of the disease, which has become the basis for dementia

Drug therapy of persons suffering from dementia, is aimed at eliminating the factors that gave start to changes in cognition.

Today, with Alzheimer's disease, prescribing for funds from the class of cholinesterase inhibitors is prescribed. The most frequently used:

• Amiridin( Amiridmum) significantly reduces disorder of memory in senile dementia due to the stimulation of central cholinergic processes.
• Tacrine( Tacrine) - the drug normalizes the processes of nervous activity, inhibits regressive processes in the brain.
• Exelon( Exelon) is recommended for moderate dementia of the Alzheimer's type.
• Donepezil( Donepezil) - a powerful tool that slows the development of dementia, reduces the severity of defects in mental activity, restoring the patient's activity, corrective behavioral disorders.

Slowing the progression of the disease is capable of carrying out substitution therapy with estrogens, nonsteroidal anti-inflammatory drugs, anti-Parkinsonian drugs, for example: Selegiline. Importance of the vitamin in dementia, in particular, vitamin E( tocopherol).

In vascular dementia, a significant role is played by pharmacological components that affect the established risk factors, including: hypotensive drugs. In order to prevent cerebral infarcts, disaggregants and anticoagulants are involved. To improve cognitive processes, the patient is prescribed nootropics for dementia, for example: Piracetam.

Important! It is expedient to use peptidergic drugs. For example: Cerebrolysinum( Cerebrolysinum) with dementia shows significant effectiveness, stimulating the metabolism in the brain tissue. It may be recommended to take antagonists of calcium ions that correct the cerebral circulation, for example: Nimodipine.

Biogenic stimulants are often included in the treatment program. For example, Actovegin in dementia stimulates cellular metabolism by optimizing transport and enhancing the accumulation of glucose and oxygen in the brain tissue.

Therapy of Emotional-Affective Disorders

In demented patients, the pathological symptoms of emotional and affective disorders, such as: depressive states, irrational anxiety, episodes of arousal, problems with sleep very often come to the fore. Therapy of such disorders is selected after a thorough evaluation of the clinical manifestations of each patient. In this case, the reaction to pharmacological treatment should be carefully inspected and periodically reviewed by the therapeutic scheme, avoiding unnecessarily long use of medications.

When arousal and signs of confusion occur in alcoholic dementia, small doses of drugs with a slight cholinolytic effect are used. For example: Haloperidol( Haloperidol) with dementia intend once in the evening, as in patients most often the above symptoms occur at night. The use of neuroleptics, such as Risperidone( Risperidone), requires special care with dementia, because the disease is quite similar to the disease with the formation of Lévy's bodies, in which the intake of drugs of this group is strictly prohibited. Particular attention is needed when choosing an antipsychotic Sonapax( Sonapax) for dementia in elderly patients.

In case of pathological anxiety, tranquilizers of the benzodiazepine series are included in the low dosage regimen. Use of highly active agents of this group, for example: Phenazepaitium with dementia of persons older than 50 years should be carried out very carefully, as they initiate a weakening of memory and can give rise to even greater anxiety afterTheir cancellation.

With obvious psychomotor agitation, agitation, irrational anxiety, hyperactivity, excessive irritability and sleep disorders, the use of chloroproticsen( Chlorprothixene) for dementia of the neuroleptic is recommended. High therapeutic effect shows Phenibut( Phenibut) in dementia: it has nootropic action, has a tranquilizing activity, eliminates tension and anxiety, normalizes sleep. Stress-protective action and antioxidant activity is possessed by Mexidol( Mexidolum), often used in dementia.

To eliminate manifestations of depression, it may often be necessary to connect antidepressant medications. More preferably, the use of agents from the group of selective serotonin reuptake inhibitors( SSRIs) or tricyclic depressants in dementia, such as: Amitriptyline( Amitriptyline).

Conclusion

The characteristics of drug treatment of individual patient groups should be considered. Since the prevailing majority of clinical cases of dementia are observed in older people with a significant number of chronic physical ailments, careful attention should be paid to the measures to ensure the normal functioning of the cardiovascular system when choosing a treatment program.

Information on the features of dementia can be obtained from the video: