(Preview) Most common diseases of 50 plus - Diseases of Central Nervous system(CNS): Dementia - Treatments of Alzheimer's disease and Diminished quality of acetylcholine

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         Diseases of Central Nervous system

                           Dementia

About 5-8% of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age. Dementia is the loss of mental ability, severe enough to interfere with people's every life and Alzheimer's disease is the most common type of dementia in aging people.

VI. Treatments
Depending to the causes of disease, most medication are to control the symptoms 
A. Alzheimer's disease and Diminished quality of acetylcholine
A.1. Treatments of mild and moderate Alzheimer's disease and Diminished quality of acetylcholine
1. Cholinesterase inhibitors 
a. Cholinesterase inhibitors are the primary treatment, including tacrine(409)(410)(Cognex), donepezil(411)(412)(Aricept), rivastigmine(407)(408)(Exelon), and galantamine (Reminyl) for reductions in acetylcholine and acetyltransferase activity(406) induced cognitive symptoms of Alzheimer disease (AD).
According to Dr. Trinh NH and the research team at the Massachusetts General Hospital, there was no difference in efficacy among various cholinesterase inhibitors(413). Persistent drug treatment had a positive impact on AD progression in advanced disease(414). 
In the article, Cholinesterase Inhibitors, posted in the Minister of health, the inhibitors, improved the effectiveness of acetylcholine either by increasing the levels in the brain or strengthening the way nerve cells response in communication between nerve cells, may temporarily promote or stabilize the symptoms of Alzheimer's disease(415).

b. Side effects are not limit to(416)(417)
b.1. Nausea    
b.2. Diarrhea    
b.3. Vomiting    
b.4. Indigestion.     
b.5. Abdominal pain    
b.6. Loss of appetite
b.7. Fatigue
b.8. Weight loss
b.9. Etc.

A.2. Treatment of moderate and Severe Alzheimer's disease and Diminished quality of acetylcholine
1. Namenda®(418)(419)(memantine), an N-methyl D-aspartate (NMDA) antagonist(420) are the most common medication used to moderate and severe Alzheimer's disease, through it's therapeutic action in uncompetitive binding to the NMDAR for preservance of the physiological function of the receptor(421). But, according to other in 2 out of 3 six month studies, memantine showed only a small beneficial effect but not in patients with vascular dementia(422).

2. Side effects are not limit to(423)(424)
b.1. Confusion
b.2. Dizziness
b.3. Drowsiness
b.4. Headache
b.5. Insomnia,
b.6. Agitation
b.7. Vomiting
b.8. Anxiety
b.9. Etc.


3. Other medications
3.1. Anticonvulsants
a. Anticonvulsants are a diverse group of pharmaceuticals used in the treatment of seizures(425), chronic neuropathic pain(426), and the clinical syndrome of Alzheimer's disease(427) by suppressing the rapid and excessive firing of neurons(428). Some researchers suggested that seizure pathophysiology may relate to increased amyloid beta-peptide production(429), causing cytoskeletal dysfunction, cerebrovascular changes, neurotransmitter dysfunction or combinations(430). By modification of these pathophysiological pathways, anti-epileptic drugs such as sodium valproate and lacosamide may be useful in the treatment of Alzheimer's disease(431)

b. Side effects are not limit to(432)(433)
b.1. Dizziness
b.2. Drowsiness
b.3. Unsteadiness
b.4. Nausea
b.5. Vomiting
b.6. Skin rashes
b.7. Etc.

3.2. Sedatives
a. A sedative or tranquilizer is a drug that calms patients(434), reduced irritability and excitement by modulating signals within the central nervous system for neuroprotection(436). The medication are highly addictive. Benzodiazepine, one of the sedative has shown to reduce Aβ plaques through its activation on Aβ-related synaptic and behavioral impairment in AD(437).

 
b. Side effects are not limit to(438)
b.1. Stomach upset
b.2. Blurred vision
b.3. Headache
b.4. Impaired coordination
b.5. Depression
b.6. Memory loss
b.7. Drowsiness
b.8. Risk of fractures and falls(435)
b.9 Etc.

3.3. Antidepressants
a. Antidepressant is a type of psychiatric medication used to treat depression(443), including mood disorder(439), dysthymia(440)(441) and anxiety disorders(442)(443). According to Purpan-Casselardit Hospital, 34.8% of patients with AD are prescribed antidepressant foe daily use in AD(444).

b. Side effects are not limit to(445)
b.1. Dry mouth, 
b.2. Blurred vision
b.5. Drowsiness, 
b.4. Dizziness
b.5. Tremors
b.6. Sexual problems
b.7. Etc. 

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References  
(406) http://www.ncbi.nlm.nih.gov/pubmed/23862185
(407) http://www.ncbi.nlm.nih.gov/pubmed/23728651
(408) http://www.ncbi.nlm.nih.gov/pubmed/19370562
(409) http://www.ncbi.nlm.nih.gov/pubmed/17636619
(410) http://www.ncbi.nlm.nih.gov/pubmed/10796507
(411) http://www.ncbi.nlm.nih.gov/pubmed/16856114
(412) http://www.ncbi.nlm.nih.gov/pubmed/16437430

(413) http://www.ncbi.nlm.nih.gov/pubmed/12517232
(414) http://www.ncbi.nlm.nih.gov/pubmed/19845950
(415) http://www.health.gov.bc.ca/pharmacare/adti/clinician/cholinesterase.html
(416) http://alzonline.phhp.ufl.edu/en/reading/mmi_cholinesterase.php
(417) http://en.wikipedia.org/wiki/Acetylcholinesterase_inhibitor
(418) http://www.ncbi.nlm.nih.gov/pubmed/25523430
(419) http://www.ncbi.nlm.nih.gov/pubmed/25523285
(420) http://www.ncbi.nlm.nih.gov/pubmed/10465680

(421) http://www.ncbi.nlm.nih.gov/pubmed/21875407
(422) http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003154.pub4/abstract;jsessionid=81B82BC5B10FAB9959A92CF39D439C21.d02t02
(423) http://www.medicinenet.com/memantine-oral/page2.htm
(424) http://en.wikipedia.org/wiki/Memantine
(425) http://www.ncbi.nlm.nih.gov/pubmed/23996793
(426) http://www.ncbi.nlm.nih.gov/pubmed/25479151
(427) http://www.ncbi.nlm.nih.gov/pubmed/20096151
(428) http://www.ncbi.nlm.nih.gov/pubmed/24565570
(429) http://www.ncbi.nlm.nih.gov/pubmed/23926248
(430) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385944/
(431) http://www.ncbi.nlm.nih.gov/pubmed/19557550
(432) http://www.webmd.com/bipolar-disorder/anticonvulsant-medication 
(433) http://en.wikipedia.org/wiki/Anticonvulsant 
(434) http://www.ncbi.nlm.nih.gov/pubmed/24552479
(435) http://www.ncbi.nlm.nih.gov/pubmed/18690999
(436) http://www.ncbi.nlm.nih.gov/pubmed/18311185
(437) http://www.ncbi.nlm.nih.gov/pubmed/20980585
(438) http://en.wikipedia.org/wiki/Sedative 
(439) http://www.ncbi.nlm.nih.gov/pubmed/19192442
(440) http://www.ncbi.nlm.nih.gov/pubmed/15738743
(441) http://www.ncbi.nlm.nih.gov/pubmed/25177490
(442) http://www.ncbi.nlm.nih.gov/pubmed/24497254
(443) http://www.ncbi.nlm.nih.gov/pubmed/23737423
(444) http://www.ncbi.nlm.nih.gov/pubmed/19735591
(445) http://www.webmd.com/depression/features/coping-with-side-effects-of-depression-treatment