About Anxiety Medication for Alzheimer's Patients

Alzheimer's is a devastating disease that robs the brain of cognitive skills and robs the person of normal behavior.
Research is being done to see how to prevent the disease and discover medication that will stop the deterioration of cognitive skills and changing behavior.
There are specific medications to help slow the deterioration of cognitive skills, but there is little available for psychotic behavior such as delusion, depression, aggression, and anxiety. Scientists hope to find medication that will effectively work on both cognitive skills and behavior symptoms.

History

• In the early 1900s, Dr. Alois Alzheimer, a German physician, performed an autopsy on a woman who had suffered years of confusion and memory problems. He discovered deposits of plaque on the nerve cells of the brain as well as twisted fibers inside the cells.
  Today, the disorder bears his name, Alzheimer's disease. Alzheimer's is a slow, progressive disease of the brain. It begins with a loss of short-term memory and progresses to the inability to reason, do simple tasks, use language effectively, and maintain normal behavior.
  Symptoms usually do not occur until after 70 years of age, however, early-onset Alzheimer's may occur in people as young as 40. Fifty percent of early-onset Alzheimer's is genetic, but for late-onset Alzheimer's, the disease is probable in 50 percent of the population 85 and older.

Types

• Alzheimer's causes cognitive deterioration and psychotic symptoms. Cognitive deterioration effects the ability to remember, understand, think, reason and to judge. Psychotic symptoms include depression, anxiety, agitation, possible aggression, hallucinations, delusions and mistaken identity.
  The psychotic symptoms fall under an umbrella of behavioral and psychological symptoms of dementia or BPSD. The treatment for BPSD is as important as the treatment of cognitive symptoms because if left untreated, the patient will experience extreme stress and anxiety. This makes it difficult for the patient and for the caregiver.

Prevention/Solution

• Diagnosing BPSD starts with an assessment of the environment and physical conditions. If the patient is agitated by a strange caregiver, then a change in caregivers may change the behavior.
  If the patient has arthritic pain, medication for the pain may ease a depressive mood. If the patient has difficulty sleeping at night, stopping afternoon naps may stop nightmares and hallucinations. If the patient still has symptoms after the underlying symptoms are taken care of, drug treatment may be required. The purpose of the drugs is to treat the psychotic symptoms and not sedate the patient.

Theories/Speculation

• There are few drugs specifically designed for psychotic behavior in Alzheimer's patients. Lorazepam, which belongs to a group of drugs called benzodiazepines, is used for anxiety and symptoms of depression due to anxiety. Lorazepam works on the brain and nerves to produce a calming effect. It comes in tablet and liquid form and is usually taken two to three time a day. Oxazepam also belongs to the group of drugs called benzpdiazepines.
  Like Lorazepam, it is used to treat anxiety, but also agitation from alcohol withdrawal. It comes in tablets and capsules. Dosage is usually three to four times a day. These two drugs are not designed specifically for Alzheimer patients, but are commonly used for mild and moderate anxiety. Risperidone is an anti-psychotic drug that is licensed to use for severe anxiety and aggression in Alzheimer's patients, but is not recommended for mild or moderate signs of anxiety.
  Sometimes doctors prescribe anti-depressants to help with mild depression and sleep aids for sleeping disorders.

Potential

• Researchers are constantly working on better diagnostic tools and prevention strategies for Alzheimer's. Improving the imaging ability of the MRI and the PET could help identify patients at risk of developing the disease. Presently, research is being used on the MRI's ability to show how different medications for generalized anxiety disorder affect the brain.
  Scientists are looking at ways to use blood, urine, or spinal fluid samples to detect the disease. Work is ongoing to find medications and vaccines that will prevent the disease and stop the disease if it has progressed. Research is also discovering that exercise and a healthy heart can deter the affects of Alzheimer's.