Treatments for Alzheimer

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Team 1

• Treatments for Alzheimers Parkinsons,
  Huntingtons and Vascular types of dementia

By Andrew, Anne, Connie and Diana
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Alzheimers Disease

• A type of dementia characterized by progressive
  neurological degeneration and deterioration of
  mental functioning.
• This disease results in impairment of
• Language
• Memory
• Visual-Spatial Orientation
• THERE IS NO CURE

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TreatmentsDrugs

• Cholinesterase Inhibitors (mild to moderate)
• Increase CNS acetylcholine (Ach) by inhibiting
  cholinesterase activity in the synapse.
• Tacrine (Cognex)Donepezil (Aricept)Galantamine
  (Razadyn (name changed from Reminyl June
  2005))Rivastigmine (Exelon)
• Side Effects
• Nausea/Vomiting
• Loss of appetite
• Increased frequency of bowel movements
• Possible liver damage (Tacrine)

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TreatmentsDrugs

• Memantine (moderate to severe)
• Works by regulating glutamate which plays a key
  role in processing, storage and retrieval of
  information.
• Namenda
• Side Effects
• Headache
• Constipation
• Confusion
• Dizziness

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Drugs

• Enbrel?
• Used for rheumatoid arthritis, ankylosing
  spondylitis, and psoriatic arthritis
• Has not been approved for Alzheimers
• Therefore insurance does not pay.
• http//www.youtube.com/watch?vOhTtJkN3o2Y
• http//www.youtube.com/watch?vrAZhX7LEZeU

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Gene Therapy Combined with Nerve Growth Factor
(NGF)

• Put extra copies of the gene in the brain of
  people with Alzheimers for cellular growth
  factor and it slows the degenerative condition.
• A study in 1996 involving monkeys (Tuszynski
  Blesch) who received grafts that produced NCF
  retained twice as many cholinergic neurons than
  those receiving control grafts.
• A clinical trial on eight patients with mild AD
  (Tuszynski and others, 2005) showed no adverse
  effects after 22 months and showed increased
  metabolic activity and an autopsy performed on
  another patient showed robust neuronal growth.

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Stem Cells

• The use of embryonic stem cells have been touted
  as possibilities in treating a variety of
  neurological diseases
• Researchers have injected human neuronal stem
  cells into the lateral ventricles of 2-month and
  24 month old rats, in the older rats it showed
  dramatic cognitive improvement (Qu others,
  2001 Sugaya, 2005).
• The use of stem cells, raises ethical concerns.

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Interventions and Reality Orientation Programs

• The use of mnemonic techniques
• Memory aids that help improve retrieval and
  storage information.
• Rely on associative processes to link events.
• Reality orientation programs
• Allows AD patients to maintain awareness of who
  they are.
• Support groups for families and caregivers.

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Parkinsons Disease

• According to the University of Maryland Medicine
  (UMM) Parkinsons disease (PD) belongs to a group
  of conditions called motor system disorders which
  are the result of the loss of dopamine producing
  brain cells.
• It is a slowly progressing degenerative disease
  that is usually associated with the following
  symptoms tremor or trembling of the arms, jaw,
  legs and face, stiffness or rigidity of limbs and
  trunk, brady-kinesia (slowness of movement),
  postural instability, impaired balance and
  coordination.

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Symptoms

• As the symptoms become more pronounced, patients
  may have difficulty walking and talking,
  sleeping, chewing, swallowing, completing daily
  tasks.
• About 50,000 Americans are diagnosed with
  Parkinsons each year. It is believed that more
  people suffer from Parkinsons than multiple
  sclerosis, muscular dystrophy and, amyotrophic
  lateral sclerosis combined.

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Prevalence and Treatments

• The prevalence of Parkinson's increases with age
  - appearing in 1 of people over 60 and 4-5 of
  those over 85 but, the average onset is usually
  in the late fifties.
• Young onset PD refers to symptoms that begin as
  early as in the twenties and thirties.
• There is no cure for Parkinsons but, treatment
  is given based on the severity of symptoms. The
  University of Maryland Medicine says that
  anti-parkinsonian medication can be prescribed
  depending on the degrees of functional
  impairment, cognitive impairment, ability to
  tolerate the medications as well as advice from
  physicians.

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Drugs

• According to the National Institute of
  Neurological Disorders and Stroke, Levadopa
  (L-Dopa), a natural chemical found in plants and
  animals, has been used for over thirty years to
  treat Parkinsons Disease. Nerve cells use the
  levadopa to make dopamine and replenish the
  brains dwindling supply. This medication helps
  about ¾ of patients. L-Dopa is used to help
  reduce brady-kinesia, rigidity and tremors.
• Other medications include Bromocriptine,
  Pramipexole, Ropinirole which all mimic dopamine
  in the brain.

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Treatment Options

• Surgery becomes an option when the disease does
  not respond to drugs any longer or at all.
• In a therapy called Deep Brain Stimulation (DBS)
  electrodes are implanted into the brain and
  connected to a device called a neurostimulator
  which can be externally programmed. This
  neurostimulator is used to deliver electrical
  stimulation to areas in the brain that control
  movement. This blocks the abnormal nerve signals
  that cause the tremors and other symptoms of
  Parkinsons Disease.

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Huntingtons Disease

• No Cure
• Medications
• Tranquilizers like Klonopin
• Antipsychotics like Haldol or Clozaril
• Antidepressants like Zoloft
• Lithium drugs like Lithobid

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Huntingtons Disease

• Physical Therapy/ Occupational Therapy
• Speech Therapy
• Picture boards
• Experimental Treatments
• Cancer Drugs and AIDS drugs
• Coenzyme Q10

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Self - Care for Huntingtons

• Proper Hydration
• Exercise Regularly
• Continue proper nutrition
• 5,000 calories per day
• Vitamins and supplements

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What is Vascular Dementia?

• Second most common form of dementia in the U.S.
  (helpguide.org).
• Caused by blockages in the brains blood supply
  (helpguide.org).
• Vascular dementia is a degenerative
  cerebrovascular disease (helpguide.org).
• Leads to a progressive decline in
  (helpguide.org)
• Memory
• Cognitive functioning
• Usually occurs between the ages of 60 and 70
  (helpguide.org).
• Affects more men than women (helpguide.org).

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Most Common Vascular Dementia

• Multi-infarct dementia (helpguide.org).
• Series of small strokes sometimes called
  transient ischemic attacks (TIAs)
• Often unnoticed
• Damages the cortex of the brain
• Temporary
• Partial blockages of blood supply
• Brief impairments in consciousness or sight
• Over time the damage caused to brain tissue
  interferes with basic cognitive functions and
  disrupts day to day functioning
• When vascular dementia occurs with other types of
  dementia (e.g., Alzheimer's) it is referred to as
  mixed dementia (helpguide.org).

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Treatment/Prevention of Vascular Dementia

• No treatment can reverse damage caused by strokes
  (psychnet-uk.com, 2008)
• Lower your risk for a stroke (helpguide.org).
• Risk for vascular dementia is nine times higher
  following a stroke
• Risk factors of vascular dementia are the same as
  for (psychnet-uk.com, 2008).
• Stroke
• High blood pressure
• Diabetes
• High cholesterol and heart disease
  (psychnet-uk.com, 2008)

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Prevention of Vascular Dementia

• Things you can do (helpguide.org)
• Dont smoke
• Exercise regularly
• Eat healthy (limit alcohol, salt and saturated
  fat)
• Try to reduce stress (relaxation techniques)
• Routine blood pressure checks
• Medications for blood pressure and blood thinners
  (e.g., Aspirin).
• Even surgery may be necessary to restore blood
  flow to the brain.
• Carotid endarterectomy removes blockage in the
  carotid artery (the main blood vessel to the
  brain) (psychnet-uk.com).

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Treatment of symptoms

• Controlling symptoms of dementia
  (psychnet-uk.com, 2008).
• Treatment varies with the specific disorder
• Medications may be need to help with aggressive
  or agitated behaviors (including behaviors
  dangerous to themselves or others)
  (psychnet-uk.com, 2008).
• Possible medications used (psychnet-uk.com,
  2008)
• Anti-Psychotics
• Beta Blockers (if related to central nervous
  system lesions).
• Serotonin-Affecting Drugs (e.g., lithium,
  trazodone, buspirone, clonazepam).
• Dopamine Blockers
• Carbamazepine
• Fuoxetine, Imipramine
• Stimulant drugs for mood (e.g., methylphenidate)

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References

• Hill, C. Treatment of alzheimers. Retrieved April
  18, 2008 from http//alzheimers.about.com/od/treat
  mentofalzheimers/a/treatments.htm
• Klein, S. B. Thorne, B. M. (2006). Biological
  psychology. Worth Washington D.C.
• Seppa, N. (2005). Neuron savers Gene therapy
  slows alzheimers disease. Retreived April 18,
  from http//www.sciencenews.org/articles/20050430/
  fob1.asp
• Helpguide.org (2007). Vascular dementia.
  Retrieved April 16, 2008 from http//www.helpguide
  .org/elder/vascular_dementia.htm
• Huntingtons Disease Society of America. (2008).
  Talking technology. Retrieved April 18, 2008,
  from http//www.hdsa.org.
• Mayo Clinic. (2008). Huntingtons disease.
  Retrieved April 18, 2008, from http//www.mayoclin
  ic.com.
• Mental health and psychology directory. (2008).
  Disorder information sheet. Retrieved April 16,
  2008 from http//www.psychnet-uk.com/dsm_iv/dement
  ia.htm
• National Institute of Neurological Disorders and
  Stroke. (2008). NINDS huntingtons disease
  information page. Retrieved April 18, 2008, from
  http//www.ninds.nih.gov/disorders/huntington/hunt
  ington.htm.
• National Institute of Neurological Disorders and
  Stroke. 2008 parkinsons disease hope through
  research. Retrieved April 19, 2008, from
  http//www.ninds.nih.gov/disorders/parkinsons_dise
  ase/parkinsons_disease.htm
• University of Maryland Medicine. (2003, May).
  Nervous system diseases Treatments for
  parkinsons diseases. Retrieved April 19, 2008
  from the University of Maryland Medical System
  Web site http//www.umm.edu/nervous/parktrmt.htm

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Wiki Page Link

• http//wiki.ggc.usg.edu/mediawiki/index.php/PSYC34
  10dementia/Team1