Tag Archives: Trazodone

Pharmacological Treatment of Dementia

General guidelines for psychotropic medication use in frail elderly patients are applicable. Systematic evidence to support the effectiveness of particular psychotropic drugs in dementia patients is limited. Therefore, choice of drug class may be based on clinical evidence, and choice of agent is often based on the side-effect profile and on the characteristics of a… Read More »

Treatment of Insomnia

Several classes of medications are used in the treatment of insomnia. They include the benzodiazepines, non-benzodiazepine hypnotics, antidepressants, and over-the-counter medications. There are six benzodiazepines that are specifically marketed as hypnotics in the United States or in Canada: flurazepam, temazepam, triazolam, estazolam, quazepam, and (in Canada only) nitrazepam. Several other benzodiazepines (e.g., lorazepam, clonazepam, oxazepam),… Read More »

Current Therapies for Insomnia

Most individuals who suffer from insomnia either self-treat with nonprescription sleep aids (e.g., antihistamines, herbal remedies), use alcohol as a sedative, or take no drug therapy at all. For those who do seek professional help (approximately one-third of insomniacs), the majority receive physician-prescribed benzodiazepine or non-benzodiazepine sedative hypnotics to treat their insomnia. Such hypnotic agents… Read More »

Sedating Antidepressants

Given the high comorbidity of insomnia and depression and / or anxiety, sedating antidepressants have considerable relevance for treating insomnia. (Note: Sedating antidepressants can effectively treat both depressive and anxious symptoms.) The sleep-promoting properties of the sedating antidepressants, as well as their lack of abuse potential or propensity to induce tolerance, make these agents viable… Read More »

Treating Dementia

Question. I am interested in your opinion on the use of Depakote and BuSpar, as opposed to benzodiazepines, in the treatment of agitation and aggression in dementia. What dosages would you suggest? Do you know of any articles reviewing these topics? Answer. There are very few controlled studies bearing on your questions; most of the… Read More »

Difficult Dementia Patient

Question. My father lives in a nursing home. After he broke his hip, he steadily deteriorated mentally. He recognizes very few people, has virtually no memory, whether short term or long term. He constantly calls for help, even when I or his sitter are next to him. He is causing quite a problem for the… Read More »

Causes and treatment of sleep disorders in the elderly

Insomnia in the elderly can have many different causes, frequently in combination (). A precise differential diagnosis is therefore required for appropriate treatment. Common causes of insomnia in the elderly are: (a) psychiatric illness – depression, dementia, and agitated dementia; (b) organic problems – cardiovascular symptoms, nocturia, chronic pain, bronchitis and asthma; (c) sleep apnoea… Read More »

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Delirium (Acute Confusional State)

Description of Medical Condition Delirium is a neurologic complication of illness and/or medication use that is especially common in older patients. The key diagnostic features are an acute change in mental status that fluctuates, abnormal attention, and either disorganized thinking or altered level of consciousness. Delirium is a medical emergency requiring immediate evaluation in order… Read More »

Chronic Illness: Current Therapies

The main goal of bipolar disorder drug treatment is to establish euthymia (stable mood with a persistent sense of well-being) without inducing mania or rapid cycling (i.e., four or more mood episodes in a 12-month period). For this reason, drug treatment usually consists of an agent or, more frequently, combinations of agents that exert both… Read More »