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Tuesday, 29 October 2013

Dementia Treatments of Multi-infarct dementia in Conventional Medicine Perspective

I. Dementia
A. About 5-8% of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age. Dementia is the loss of mental ability that is severe enough to interfere with people's every life and Alzheimer's disease is the most common type of dementia in aging people. American typical diet contains high amount of saturated and trans fat, artificial ingredients with less fruits and vegetable which can lead to dementia and other kind of diseases.

B. Multi-infarct dementia
Also known asvascular dementia , is the second most common form of dementia after Alzheimer's disease in older adults. It is caused by different mechanisms all resulting in vascular lesions in the brain. Major depression, depressed mood/anhedonia, and subjective and neurovegetative symptoms of depression that were unaccompanied by depressed mood/anhedonia in patients with clinically-diagnosed Alzheimer's disease (AD) and multi-infarct dementia (MID), as separate entities in AD and MID(a).

II. Treatments of Multi-infarct dementia
There are no treatments which can reverse the damage to the brain caused by small strokes, but the goal of the treatment is to control the symptoms and reduce the risk factors to prevent future strokes. In order to make the blood thinner to reduce the risk blood clot causes of future stroke, your doctor may order
A. Medication  
1. Plavix
Plavix tablets which is rescription-only medicine that helps keep blood platelets from sticking together and forming clots(2) with the main function to prevent blood clotted causes of future stroke.

b. Side effects are not limit to
According to the article of Plavix Side Effects (b), the author(s) wrote that Plavix has been studied thoroughly in clinical trials, with more than 17,500 people having been evaluated. In these studies, side effects are always documented and compared to those that occur in a similar group of people not taking the medicine always documented and compared to those that occur in a similar group of people not taking the medicine. The most common side effects of Plavix (occurring in more than 2 percent of people and more often in the group taking Plavix) include:
b.1. Major bleeding
b.2. Flu-like symptoms
b.3. Headache
b.4. Dizziness
b.5. Diarrhea
b.6. Upset stomach or indigestion
b.7. Bruising, Bloody nose
b.8. Unexplained rash
b.9. Itchy skin
b.10. Etc.

2. Antipsychotics (olanzapine, quetiapine)
a. Antipsychotic drugs effectively treat psychosis caused by a variety of conditions (Table 1, including dementia). Psychotic symptoms are classified as either positive or negative. Positive symptoms include hallucinations, delusions, thought disorders (manifested by marked incoherence, derailment, tangentiality), and bizarre or disorganized behavior. Negative symptoms include anhedonia, flattened affect, apathy, and social withdrawal(2).

b. Side effects are not limit to
B.1. Constipation, 
b.2. Dry mouth and 
b.3. Blurred vision
b.4. Sleepiness and slowness 

b.5. Weight gain
b.6. Stiffness and shakines
b.7. Hormone change
b.8. Diabetes
b.9. Etc.

3. Serotonin-affecting drugs (trazodone, buspirone, or fluoxetine)
a. In the study to investigate of Ten patients with severe dementia due to Alzheimer's disease (AD) or multi-infarct dementia (MID) or both, were treated with the precursor amino acids of the neurotransmitters serotonin and dopamine, conducted by Dr. Meyer JS and the research team showed that analysis of the cerebrospinal fluid for HVA and 5-HIAA before and after the probenecid test indicated some improvement in the metabolic turnover of these acid metabolites of serotonin and dopamine after administration of their precursor amino acids(3).

b. Side effects are not limit to
b.1. Trembling
b.2. Blood-pressure changes
b.3. Confusion
b.4. Dizziness
b.5. Diarrhea and/or vomiting
b.6. Irregular heartbeat
b.7. Loss of coordination
b.8. Loss of bladder control
b.9. Etc.

4. Anti anticonvulsant
a. Scientists at the East Carolina University School of Medicine, reported that a patient with multi-infarct dementia and associated hypomanic features was treated effectively with clonazepam to control logorrhea, hyperactivity, agitation, intrusiveness, and impulsive violence and to promote cooperation and manageability(4).

b. Side effects are not limit to
b.1. Dizziness
b.2. Drowsiness
b.3. Unsteadiness
b.4. Nausea
b.5. Vomiting
b.6. Skin rashes
b.7. Etc.

5. Rivastigmine 
In the study to determine the effects of rivastigmine on cognitive function, global daily living performance, and behavioral disorders in VaD patients versus an active control (nimodipine), stratifying patients according to the type of VaD, subcortical vascular dementia (sVAD), and multi-infarct dementia (MID) at the University of Trieste, indicated that hat long-term treatment with rivastigmine, at dosages approved for therapeutic use in Alzheimer's disease, produces significant improvement in all behavioral symptoms in 2 forms of VaD, MID and sVaD, except delusions. It also suggests that rivastigmine may enable a reduction in concomitant neuroleptics and benzodiazepines in VaD, especially in MID(5).

b. Side effects are not limit to
b.1. Nausea and vomiting
b.2. Loss of appetite
b.3. Weight loss
b.4. Diarrhea
b.4. Dizziness
b.5. Drowsiness
b.6. Trembling
b.7. Etc.

B. Surgery
In case of sensory problems, surgery can be helpful.

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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/22164676
(1) http://en.wikipedia.org/wiki/Clopidogrel
(2) http://www.aafp.org/afp/2003/0601/p2335.html 
(3) http://www.ncbi.nlm.nih.gov/pubmed/301148
(4) http://www.ncbi.nlm.nih.gov/pubmed/3252876
(5) http://www.ncbi.nlm.nih.gov/pubmed/18184948