Psychopharmacological Issues in Geriatrics

Drugs Used in the Treatment of Dementia and Neurocognitive Disorders

Author(s): Juan Medrano

Pp: 325-332 (8)

DOI: 10.2174/9781681080345115010018

* (Excluding Mailing and Handling)

Abstract

Dementia is a devastating illness for which currently there is no curative treatment. In the last twenty years, acetylcholinesterase inhibitors have been approved in mild to moderate stages of the illness to delay the progression of Alzheimer’s disease, the most prevalent form of dementia, while memantine has been approved for later stages. Clinical experience shows that drug treatment of cognitive symptoms is of little benefit, but there is evidence that both acetylcholinesterase inhibitors and memantine could be helpful to alleviate the behavioral and psychological symptoms of dementia, especially in variants where other alternatives, such as antipsychotics, can be detrimental.


Keywords: Acetylcholinesterase inhibitors, Alzheimer’s disease, Antipsychotics, Behavioral and psychological symptoms of dementia, Citicoline, Dementia, Dihydrotoxine, Donepezil, Galantamine, Huperzine A, Lewy body disease, Meclofenoxate, Memantine, Mild cognitive impairment, Neurodegeneration, Nicotinic receptors, NMDA receptors, Parkinson’s disease, Piracetam, Psychosis, Rivastigmine, Tacrine, Transdermal rivastigmine, Vascular dementia, Vasodilators.

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      • 11. app/Models/ContentAccess.php:647
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      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314530707 and j.to_ip >=314530707 )) and ((j.from_date <= 1739834417 and j.to_date >= 1739834417 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7561) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314530707 and j.to_ip >=314530707 )) and ((j.from_date <= 1739834417 and j.to_date >= 1739834417 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7561) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314530707 and j.to_ip >=314530707 )) and ((j.from_date <= 1739834417 and j.to_date >= 1739834417 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7561)
      960μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 1717 and `b`.`banner_from_date` <= 1739834417 and `b`.`banner_to_date` >= 1739834417 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.09msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 1717
      • 3: 1739834417
      • 4: 1739834417
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='e513edce0b3ce195fa6c26aaaa09e635'
      240μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    25Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        QtYIg74ZugmzNRfaqe7zEbhdQeGGjPTh9z7d0inU
        uc_cart_id
        e513edce0b3ce195fa6c26aaaa09e635
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7561" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/7561
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6InFRR1RFM1cyUjN5K1l0RUFxUCtFSkE9PSIsInZhbHVlIjoiRjgyUzF2LzRBODB4UHRPaWY2SVBNeXpzZGhJZUJTL0ZMSnZnaVpyOG5sST0iLCJtYWMiOiI1OTEyMWFlZjk5M2VlZGE4YjFhMmU2NGJjOGI2NDA4YTU3ODZhMDM5YjU2MGMwOWY1ZDUwNDdlYTJjZjI3N2QzIiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6InFRR1RFM1cyUjN5K1l0RUFxUCtFSkE9PSIsInZhbHVlIjoiRjgyUzF2LzRBODB4UHRPaWY2SVBNeXpzZGhJZUJTL0ZMSnZnaVpyOG5sST0iLCJtYWMiOiI1OTEyMWFlZjk5M2Vl" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Mon, 17 Feb 2025 23:20:17 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IldNRjJkMWxNUG9QK3pZempZUG10dmc9PSIsInZhbHVlIjoiSVUydW1WVExyUk8wZnZiOGQvWEIrbEZuakJ0eUY1elBRZXE4QmdUdUU4SjFVRythZDFqdmhOdlhBcldiOHlYdTRzR2drdXY5am55T0JwOGJ0Z3FxVEU1eVBMaW9namJqSDJpQnJkVVpYVUZSLzNxREttUXF2aXpmK1ZuVTdsT1giLCJtYWMiOiJkYmNhYjI5NTVhYjNkZTY1NzIxOGU5YjAzNjI0NGUxOTM2NjMzMzViOGE0ZDBjZjljNjI5ZDk4MzU2ZjAyMWI4IiwidGFnIjoiIn0%3D; expires=Thu, 20 Feb 2025 11:20:17 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IldNRjJkMWxNUG9QK3pZempZUG10dmc9PSIsInZhbHVlIjoiSVUydW1WVExyUk8wZnZiOGQvWEIrbEZuakJ0eUY1elBRZXE4QmdUdUU4SjFVRythZDFqdmhOdlhBcldiOHlYdTRzR2drd" 1 => "alphaeurekaselectnet_session=eyJpdiI6InJjVzAxRWk4RVQwTzEyejdUOXd2bkE9PSIsInZhbHVlIjoiTnpXWDErdGVkNmVUcytpTWtVaVlhTGxkbm5wZlV5allLbzFqR3BRcEJwNjNPOHRqczhOQk5GY3VTY0lCREZYRVVad3dCWWZkSzBIaXUxcUJxWVl4UDRqcWJSQkt5SnF0a0ZlNmJNa2FodzZyTnZESGFKWXFzSzJnbXkrVDFhZkoiLCJtYWMiOiI2MjdjNDgxNzNiYjgxNWRiNzA4OTYwZGU4MzAyNDlhZmRhMjdlZmJiNzgyODBiYWQ5MTdhMWIwNmVjNDAwNzY4IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6InJjVzAxRWk4RVQwTzEyejdUOXd2bkE9PSIsInZhbHVlIjoiTnpXWDErdGVkNmVUcytpTWtVaVlhTGxkbm5wZlV5allLbzFqR3BRcEJwNjNPOHRqczhOQk5GY3V" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IldNRjJkMWxNUG9QK3pZempZUG10dmc9PSIsInZhbHVlIjoiSVUydW1WVExyUk8wZnZiOGQvWEIrbEZuakJ0eUY1elBRZXE4QmdUdUU4SjFVRythZDFqdmhOdlhBcldiOHlYdTRzR2drdXY5am55T0JwOGJ0Z3FxVEU1eVBMaW9namJqSDJpQnJkVVpYVUZSLzNxREttUXF2aXpmK1ZuVTdsT1giLCJtYWMiOiJkYmNhYjI5NTVhYjNkZTY1NzIxOGU5YjAzNjI0NGUxOTM2NjMzMzViOGE0ZDBjZjljNjI5ZDk4MzU2ZjAyMWI4IiwidGFnIjoiIn0%3D; expires=Thu, 20-Feb-2025 11:20:17 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IldNRjJkMWxNUG9QK3pZempZUG10dmc9PSIsInZhbHVlIjoiSVUydW1WVExyUk8wZnZiOGQvWEIrbEZuakJ0eUY1elBRZXE4QmdUdUU4SjFVRythZDFqdmhOdlhBcldiOHlYdTRzR2drd" 1 => "alphaeurekaselectnet_session=eyJpdiI6InJjVzAxRWk4RVQwTzEyejdUOXd2bkE9PSIsInZhbHVlIjoiTnpXWDErdGVkNmVUcytpTWtVaVlhTGxkbm5wZlV5allLbzFqR3BRcEJwNjNPOHRqczhOQk5GY3VTY0lCREZYRVVad3dCWWZkSzBIaXUxcUJxWVl4UDRqcWJSQkt5SnF0a0ZlNmJNa2FodzZyTnZESGFKWXFzSzJnbXkrVDFhZkoiLCJtYWMiOiI2MjdjNDgxNzNiYjgxNWRiNzA4OTYwZGU4MzAyNDlhZmRhMjdlZmJiNzgyODBiYWQ5MTdhMWIwNmVjNDAwNzY4IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6InJjVzAxRWk4RVQwTzEyejdUOXd2bkE9PSIsInZhbHVlIjoiTnpXWDErdGVkNmVUcytpTWtVaVlhTGxkbm5wZlV5allLbzFqR3BRcEJwNjNPOHRqczhOQk5GY3V" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "QtYIg74ZugmzNRfaqe7zEbhdQeGGjPTh9z7d0inU" "uc_cart_id" => "e513edce0b3ce195fa6c26aaaa09e635" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7561" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-17 23:20:17GET/chapter/75611121927