What Is The Guideline Of Pharmacological Management Of Depression?

Published studies of psychosocial factors or interventions associated to PDN were reviewed. This included a search of the following electronic databases, from 1946 to up to 10 August 2017: Medline, Embase, PsycInfo, Cinahl, Web of Science, ISRCTN registry, ClinicalTrials.gov registry, and EU Clinical Trials registry. Also, the reference lists of all included papers and of related published reviews (e.g., Eccleston et al., 2015) were screened to identify any additional eligible studies.

7. Generally, PD causes anorexia, decreased sense of smell, constipation, dry mouth, difficulties chewing and swallowing. What interventions are used to address these issues?

There are many treatments out there now like medication, therapy, surgery, and clinical trials. All these treatments are aimed to increase the level of dopamine in the system. There are many different medications out there that are used for PD patients. These are Carbidopa-levodopa, Carbidopa-levodopa Infusions, Dopamine agonists, MAO-B Inhibitors, Catechol-O-methyltransferase (COMT) Inhibitors, Anticholinergics, and Amantadine. There are many pros and cons to these medications the side effects that come with each of these medication makes it worth taking but having to find other medications to go along with the side effects of the original meds you are taking. Carbidopa-levodopa is the most effective medication out there for PD patients. A

The elevated striatal dopamine levels induced by rasagiline-dependent MAO-B inhibition has been correlated to improvements in PD motor symptoms in both monotherapy and adjunctive therapy studies. The TEMPO (TVP-2012 in Early Monotherapy for Parkinson’s Disease Outpatients) study, a 26-week, randomized, double-blind and placebo-controlled clinical trial observed the efficacy of rasagiline as a monotherapy for 404 early PD patients. Efficacy of rasagiline was quantified using the Unified Parkinson’s Disease Rating Scale (UPDRS), a rating scale used to measure the progression of PD by scoring four primary categories of symptoms: mentation, behavior and mood; activities of daily living; motor examination; and complications of therapy. Higher UPDRS scores correspond to greater severity of disease with the maximum possible score of 199 points representing total disability. The patients in the TEMPO trial had a mean baseline UPDRS score of 25 points and were subsequently divided into three groups: 1 mg rasagiline qd, 2 mg rasagiline qd or placebo. At the end of the trial period, compared with the placebo group, the average change in total UPDRS score was -3.56 for the 2 mg rasagiline group and -4.20 for the 1 mg rasagiline group. Of the four UPDRS categories, the greatest change was observed in the motor examination sub-scale with a mean change of -2.71 for the 1 mg rasagiline group and -1.68 for the 2 mg rasagiline group. This reduction in UPDRS score, especially with regards to

The FDA has not approved any specific medications to treat ASPD, but doctors will prescribe medications to treat associated symptoms for anxiety, depression, or aggression.

Identification of prodromal symptoms (e.g., substance abuse, anxiety, and mood disturbances) before PD fully developing has an important clinical implication. Treatment of comorbid psychiatric conditions is equally critical as treatment of

This metaanalysis analyzed four different treatments in the management of PPD. Treatment one and two consisted of Fluoxetine or placebo medication. The third and fourth treatment included Fluoxetine or placebo medications coupled with one or six sessions of CBT. By the end of the study the researchers observed that there was a reduction in depression in all groups. Specifically, the Fluoxetine group showed greater improvement than the placebo group. Furthermore, the six CBT therapy sessions proved to be more beneficial than the one CBT therapy session. It was also observed that women in the Fluoxetine and CBT group did not show significantly greater improvement than individuals who received just the Fluoxetine alone. Although results were observed to be greater in the Fluoxetine group, CBT was shown to be beneficial whether coupled with or without pharmacological assistance. In sum, the results of the study were found to be inconclusive. This is due to that the participants were only experiencing mild PPD. Therefore, a wider

These drugs have been joined in recent years by a third group, the second-generation antidepressants, of which there are an upwards of 30 different kinds. The MAO inhibitors were originally intended to treat TB and the doctors noticed that the medication seemed to make patients happier. It works biochemically by slowing down the body’s production of MAO. Sometimes patients may experience a dangerous rise in blood pressure if they eat foods containing tyramine (cheese, bananas, etc.), but an introduction of a skin patch has helped to curb this issue. Tricyclics were discovered while searching for medications to help schizophrenia when researchers found that imipramine relieved depressive symptoms. Comparatively, patients have been known to improve at a rate of 60% - 65%. Most patients who immediately stop taking tricyclics upon symptom relief will relapse within the year, while that number drops drastically in those who continue treatment for at least five additional months (Corey, 2013). Since, unlike MAO inhibitors, these do not require dietary restrictions, they are prescribed much more often. Some patients have even been known to show higher rates of improvement as a result. Second-generation antidepressants are another option, often selected for their effectiveness and speed of action, as well as increased difficulty in

The non-ergot dopamine agonist pramipexole is currently indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease and for the treatment of moderate-to-severe primary restless legs syndrome. A new extended-release formulation of pramipexole has now also been launched in Europe and the US to improve ease of use, compliance and provide a more continuous therapeutic effect over 24 hours. Before initiating any treatment, the benefit-risk ratio to the individual patient must be considered. For pramipexole in the treatment of Parkinson's disease, this means taking into account the available evidence regarding its symptomatic efficacy, effect on delaying long-term levodopa-related motor complications, beneficial effect

The Pasternak et al publication was a Danish study that investigated the correlation between PD and CCB use via a retrospective cohort study using the Danish Civil Registration System, with an Oxford 2b level of evidence. The primary goal of this study was to determine if the incidence rate of PD in new users of DHPs differed significantly from those non-users, when studying the Danish population ≥45 years of age between January 1, 1998 and December 31, 2006. Researchers also hoped to evaluate PD rates among specific DHPs, non-DHP CCBs, as well as rates of dementia and death among patients on CCBs. Patients were excluded from the study if they had used a CCB within 2 years prior to the study, or had pre-existing PD or PD-related dementia at the study onset. Patients use of CCBs was stratified as: use (filling at least two consecutive prescriptions), past use, or 1 time use. PD diagnosis during the study was defined as those individuals who had at least one hospital diagnostic code for PD in addition to receiving at least one prescription for antiparkinson dopaminergic therapy.

Parkinson’s Disease is a long-term progressive neurodegenerative disease consisting of motor system impairment, neuropsychiatric, and nonmotor features. The disease is characterized by the following key clinical features: bradykinesia, resting tremor, postural instability, and rigidity. These symptoms are due to the diminishing of dopamine in the nigrostriatal pathway and substantia nigra, which causes inhibition of the thalamus decreasing excitatory input to the motor cortex.1 Along with the key manifestations an individual with Parkinson’s Disease will experience problems associated with the disease or the antiparkinson medications. These co-occurring problems are hallucinations, dementia, daytime sleepiness, fatigue, depression, and pyschosis.2 Psychosis is a common problem in Parkinson’s Disease, and is characterized by paranoid delusions and hallucinations that are visual in nature.2 Risk factors for psychosis consists of advancing age, dementia, sleep disorders, and high doses of antiparkinson drugs.1

Tremor is the main symptom of PD but there are other simple symptoms like loss of balance, change in speech and slow movement. Many people and scientists in general believe that head damage or backbone damage as a result of accidents and other problems are the main cause of PD (Mayeux, 143). However, recent studies have indicated that psychiatric disorders are main cause of this PD. The main mental illness disorders that have been associated with PD are anxiety, affected disorders and schizophrenia. However, other issues such as trauma, depression and stress are risk factors for PD. Recent studies have provided different results on the relationship between psychiatric disorders and PD and the studied had many limitations especially due to bias and that is why this research was conducted to provide more reliable information on the relationship between psychiatric disorder and PD. However, the reliability of this research has not yet been guaranteed and that is why the study will be put under critique in this paper.

Frank (2014) explains that the treatments for Huntington’s usually target hyperkinetic movement disorders, including chorea, dystonia, ballism, myoclonus, and tics. Tetrabenazine (TBZ) is considered one of the most effective agents for chorea, explains Frank (2014), however other medications like dopamine antagonists, benzodiazepines, and glutamate antagonists are also viable candidates towards treating chorea symptoms. Several studies that Frank (2014) presents show that atypical drugs like olanzapine, quetiapine, and aripriprazole show very positive results in treating chorea. In “Huntington’s disease” (2016) various medications are cited that may help alleviate behavioral and psychiatric symptoms such as fluoxetine, sertraline, nortriptyline for depression, lithium for mood swings or pathological excitement, and also cites that other medications may be needed to address obsessive-compulsive rituals in some individuals. Both Frank (2014) and “Huntington’s disease” (2016) advise that side effects need to be taken into consideration when prescribing particular medications, for example Frank (2014) writes that “providers should consider if there will be a positive or negative effect of the agent on psychiatric issues associated with HD, such as irritability, depression, anxiety, mania, apathy, obsessive–compulsive disorder, or cognitive

Although the study provides valuable information by adding to what is known about the pharmacokinetics, efficacy and safety of Nilotinib in PD, there are some flaws in this research. First, the basis for this study is the assumption that Nilotinib, being a c-ABL inhibitor (Manley et al., 2010), can prevent the build-up of neurotoxic substrates in the brains of PD patients, thus improving symptoms (Karuppagounder