Pharmacotherapies for Behavioral and Psychological Symptoms of Dementia with Alzheimer’s Disease: Two Subcategories of these Symptoms

We previously reported that aging process and disease progression of Alzheimer’s disease (AD) connected depressive symptoms (affective disturbance and anxiety) with psychotic symptoms such as delusion, hallucination and aggressiveness. These features are mixed state of manic state and depressive state, therefore, there might be relationship between bipolarity (BT) and psychological symptoms of dementia (BPSD) in AD. From these reports, we considered that BPSD in AD should be treated as “augmentation” (pharmacotherapy for bipolar disorder) .

Psychological Symptoms of Dementia
Psychological Symptoms of Dementia

In this previous article, we proposed the reasonability of prescribing the atypical antipsychotics for BPSD in AD. However, in Japan, there are currently no licensed medicines for the management of BPSD in AD patients although in case of oldest old patient antidepressant is useful for ameliorating BPSD in AD.

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Transcutaneous Auricular Vague Nerve Stimulation: A Promising Alternative Therapy for Insomnia Disorder

Insomnia disorder (ID) is a common condition that includes difficulty in initiating sleep, maintaining sleep, waking up too early, and nonrestorative or poor-quality sleep, all of which are commonly associated with symptoms of daytime functional impairment. According to a WHO collaborative study in 14 countries, 16% of correspondents had difficulty falling asleep; 25% of the correspondents either experienced difficulty staying asleep or woke up too early. The prevalence is even higher in the elderly and twice as high in women as in men.

Insomnia disorder
Insomnia disorder

Daytime complaints of people with insomnia concern cognitive functioning, fatigue, and depressed mood. Moreover, insomnia leads to higher risks of depression, anxiety and cardiovascular diseases. Daytime consequences and functional impairment caused a heavy economic burden to the society. It was estimated that the total annual cost of insomnia in 1994 was approximately $30-$35 billion in the USA. Now-a-days, the number should be much higher.

Role of Cav2.1 Channel Signaling in Glutamate-Related Brain Injury

Cerebral ischemia, seizures, traumatic brain injury. Neuroprotection has been studied worldwide in the context of brain injuries, including neurodegenerative diseases, cerebral ischemia, epilepsy and seizures, and traumatic brain injury (TBI). Cerebral ischemia is one of the most common causes of death in adults worldwide, resulting in necrosis and apoptosis in the brain that in turn leads to a high possibility of ischemic stroke-related disability . Epilepsy, characterized by multiple, unpredictable seizures, is a common neuronal disease in human populations regardless of age, sex, or race.

Glutamate-Related Brain Injury
Glutamate-Related Brain Injury

Approximately 1% of the population worldwide is known to have epilepsy, which often requires lifelong medication. TBI, which is typically due to falls or motor vehicle- or sports-related accidents, is a serious health issue regardless of age. Approximately 1.4 million patients visit emergency rooms in the USA each year due to TBI. The need for treatment of such brain injuries appears to be dramatically increasing. Therefore, in this paper, we review the role of the Cav2.1 channel in cerebral ischemia, seizures, and TBI.

New Bioethical Aspects of Ending of Life in Unresponsive Wakefulness Syndrome/Vegetative State Patients

The active abandonment of patients in Unresponsive Wakefulness Syndrome/Vegetative State (UWS/VS) is a topic that has been widely discussed in recent decades by individual authors advocating directly opposite points of view.The reason is that the issue is approached from different schools of thought, sometimes opposing each other, which envelope their views in a false contrast between religious and secular bioethics, supported by the intransigence of their specific ideology or religious beliefs.

Wakefulness Syndrome
Wakefulness Syndrome

Recent progress in scientific research, on the physiopathology of UWS/VS, and the high rate of misdiagnosis now allows us to consider the issue of ending of life, by active suspension of nutrition and hydration from a new point of view, which might break down the existing contrast and bring the two ideologies together.