Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Depressive symptoms, due either major depression or clinically significant, subsyndromal depression, occur commonly in the course of Alzheimer's disease. For a variety of clinical and methodological reasons, this remains an area that begs for new investigation. At the very least, these depressive symptoms should be viewed as a cause of significant and treatable "excess disability" (Kramer and Reifler, 1992). Demented patients with clinically significant depression (e.g., depressed mood, significant loss of appetite, insomnia, fatigue, irritability, and agitation) should be considered for a trial of antidepressant therapy, even when they fail to meet full diagnostic criteria for major depression. These symptoms will, in most instances, respond to antidepressant therapy. The "rules" for treatment of depression in dementia are slightly different than for cognitively intact patients: (a) start low, go slower, (b) pay attention to cognitive toxicity of all medication combinations, and (c) depressive symptoms do not persist as long as in cognitively intact patients. Current treatments, especially those SSRI's like fluoxetine and sertraline that have cognitive enhancing effects, should be considered the "first line" antidepressants. We need to emphasize early detection and treatment of depressive symptoms in dementia in all arenas.
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PMID:Depression and Alzheimer's disease. 980 20

Demented elderly people often show severely fragmented sleep-waking patterns and are associated with disorganized circadian rhythm. Frequent nocturnal awakening and associated behavioral and psychological symptoms in demented people place a heavy burden on their families and care givers, and the development of an effective therapy is an important concern to health care practitioner and researchers. Although sleep disturbances in demented people could be classified into not only insomnia type but also irregular pattern type, differentiation has not yet been sufficiently practiced in a clinical setting. Demented people with irregular sleep pattern increase with progressive stage and are often insensitive to the usual pharmacotherapies for insomnia using benzodiazepines or antipsychotics. From the viewpoint of risk-benefit balance, chronotherapies such as artificial bright light or improvement of sleep hygiene could be useful and safety tools for sleep and behavioral problems in the demented elderly.
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PMID:[Sleep disorders and sleep medicine in demented patients]. 2256 19