Alzheimer's Disease: A Handbook for Caregivers

By Ronald C. Handy; James M. Turnbull et al. | Go to book overview

Chapter 4
Specific Drug Therapy

Sharon Wyatt Moore

It is impossible to cure all patients; that would
be an achievement surpassing in difficulty even
the forecasting of future developments.

—Hippocrates


INTRODUCTION

Prior to the 1970s, approved treatment options were unavailable for the memory problems associated with dementia. Although few such drugs are commercially available at this time, many areas of research appear promising for new drug development. Extensive efforts are underway to understand the mechanisms of nervous system pathology of patients with Alzheimer's disease, and such insights are critical to develop effective treatments. It is now clear that there is not one specific defect in the disease, but several processes or pathways are affected. Certainly, the progress researchers have made in the last 20 years gives families hope for future breakthroughs to ease the suffering now endured. New efforts are also underway to determine whether some medications may help prevent Alzheimer's disease.

This chapter will attempt to provide the reader with an overview of the major medications previously used, currently used, and now under study for the treatment of this disease. None have the prospect of curing Alzheimer's disease, but some patients may experience beneficial effects or delayed worsening. Because all medications have possible side effects, the physician must weigh the risks and benefits with each medication decision.

With any treatment measure, it is especially important for the physician to exclude delirium, psychosis, and potentially reversible causes of dementia before starting therapy.


HYDERGINE

Hydergine (generic name, ergoloid mesylates) is a combination of four derivatives of ergotoxine and was the first medication approved by the United

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Alzheimer's Disease: A Handbook for Caregivers
Table of contents

Table of contents

  • Alzheimer's Disease - A Handbook for Caregivers *
  • Contributors v
  • Reviewers ix
  • Foreword from First Edition xiii
  • Preface xv
  • Acknowledgments xvii
  • Contents xix
  • Chapter 1 - Alzheimer's Disease: an Overview 1
  • Unit One *
  • The Normal Brain *
  • Chapter 2 - Higher Brain Functions 11
  • Chapter 3 - Neuropsychological Assessment of Dementia 27
  • Chapter 4 - Imaging the Brain in Alzheimer's Disease 41
  • Unit 2 *
  • Alzheimer's Disease *
  • Chapter 5 - Historical Perspectives 51
  • Chapter 6 - Etiology and Pathogenesis: Current Concepts 60
  • Chapter 7 - Clinical Presentation 74
  • Chapter 8 - Clinical Diagnosis 87
  • Chapter 9 - Factors That Aggravate the Symptoms 104
  • Chapter 10 - Other Dementias 117
  • Unit Three *
  • Management *
  • Chapter 11 - General Principles of Management 143
  • Chapter 12 - Management of Difficult Behaviors 150
  • Chapter 13 - Psychopharmacology in Dementia 171
  • Chapter 4 - Specific Drug Therapy 183
  • Chapter 15 - Urinary and Fecal Incontinence 199
  • Chapter 16 - Management of Urinary Incontinence 213
  • Chapter 17 - Safety and Accident Prevention 227
  • Chapter 18 - Daily Care and Management 243
  • Chapter 19 - Developing a Day's Activity 259
  • Chapter 20 - Terminal Care of the Patient 276
  • Unit 4 *
  • Special Issues *
  • Chapter 21 - Ethical Issues 293
  • Chapter 22 - Legal Issues for Caregivers 306
  • Chapter 23 - Stress in Caregivers 316
  • Chapter 24 - Elder Abuse 328
  • Unit Five *
  • Community Support *
  • Chapter 25 - Caregiver Education and Support 341
  • Chapter 26 - Social Services 354
  • Chapter 27 - The Alzheimer's Association 367
  • Chapter 28 - Dementia Care Units 377
  • Unit Six *
  • Future Prospects *
  • Chapter 29 - Promising Areas of Research 393
  • Appendix A - Some Useful Addresses and Phone Numbers 399
  • Appendix B - Additional References 415
  • Glossary 423
  • Index 441
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