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  1. Article: Rivastigmine in the treatment of Alzheimer's disease: an update.

    Onor, Maria Luisa / Trevisiol, Marianna / Aguglia, Eugenio

    Clinical interventions in aging

    2007  Volume 2, Issue 1, Page(s) 17–32

    Abstract: Alzheimer's disease is the most common form of dementia in industrialized countries. In the European Union, about 54% of dementia cases are believed to be due to Alzheimer's disease. The condition is an age-related neurodegenerative disorder ... ...

    Abstract Alzheimer's disease is the most common form of dementia in industrialized countries. In the European Union, about 54% of dementia cases are believed to be due to Alzheimer's disease. The condition is an age-related neurodegenerative disorder characterized by multiple cognitive deficiencies, including loss of memory, judgment, and comprehension. These manifestations are accompanied by behavioral and mood disturbances. Although no cure has yet been discovered for Alzheimer's disease, symptomatic therapies are now widely available and offer significant relief to patients and benefits to caregivers in terms of reduced care burden. At the start of the 21st century, health technology assessments recommended three agents for the symptomatic treatment of mild to moderate Alzheimer disease: rivastigmine, donepezil, and galantamine. Rivastigmine (Exelon, Novartis Basel-Switzerland) is a slowly reversible inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), while donepezil (Aricept, Pfizer, New York, USA) and galantamine (Reminyl, Janssen, New Jersey, USA) show no functional inhibition of BuChE, and are considered AChE-selective, rapidly-reversible inhibitors. The efficacy of all three agents has been evaluated in large, double-blind, placebo-controlled clinical trials of up to 6 months' duration. Rivastigmine treatment in mild to moderate Alzheimer's disease improves cognition, activities of daily living, and global function.
    MeSH term(s) Alzheimer Disease/drug therapy ; Behavior/drug effects ; Clinical Trials as Topic ; Humans ; Lewy Body Disease/drug therapy ; Neuroprotective Agents/adverse effects ; Neuroprotective Agents/pharmacokinetics ; Neuroprotective Agents/pharmacology ; Neuroprotective Agents/therapeutic use ; Phenylcarbamates/adverse effects ; Phenylcarbamates/pharmacokinetics ; Phenylcarbamates/pharmacology ; Phenylcarbamates/therapeutic use ; Rivastigmine
    Chemical Substances Neuroprotective Agents ; Phenylcarbamates ; Rivastigmine (PKI06M3IW0)
    Language English
    Publishing date 2007-11-28
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2364924-0
    ISSN 1176-9092
    ISSN 1176-9092
    DOI 10.2147/ciia.2007.2.1.17
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Efficacy and tolerability of quetiapine in the treatment of behavioral and psychological symptoms of dementia.

    Onor, Maria Luisa / Saina, Marisa / Aguglia, Eugenio

    American journal of Alzheimer's disease and other dementias

    2006  Volume 21, Issue 6, Page(s) 448–453

    Abstract: Behavioral symptoms start to appear in mild and moderate dementia and become increasingly severe with the progression of the disease. Agitation, aggressiveness, and psychosis can be seen in Alzheimer's disease, and in particular are common manifestations ...

    Abstract Behavioral symptoms start to appear in mild and moderate dementia and become increasingly severe with the progression of the disease. Agitation, aggressiveness, and psychosis can be seen in Alzheimer's disease, and in particular are common manifestations in Lewy body dementia. It is the behavioral disturbances rather than the cognitive disorders that are more often the cause of the institutionalization of these patients because of the heavy assistance and emotional burden they represent for caregivers. Traditionally, these kinds of symptoms were controlled by classical antipsychotic agents, which after long-term use cause severe extrapyramidal effects, late dyskinesia, sedation, orthostatic hypotension, and cognitive function impairment. More recently, atypical antipsychotic agents have shown a better tolerability profile, with a reduced incidence of extrapyramidal effects, orthostatic hypotension, sedation, and a reduced impact on cognitive function. The aim of this study is to evaluate the efficacy and tolerability of quetiapine in a group of patients with a diagnosis of dementia and concomitant psychotic disorders. The response to treatment was evaluated by the Neuropsychiatric Inventory (NPI) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). The NPI and BEHAVE-AD were administered at baseline and after 4 weeks and 12 weeks of therapy. Tolerability was assessed by the incidence of clinically evident side effects. The results show that quetiapine is effective in reducing behavioral symptoms, deliria and hallucinations, aggressiveness, and sleep disturbances. Quetiapine tolerability proved to be satisfactory. The only side effect of clinical significance was orthostatic hypotension, which was, however, partially preventable by a slower drug titration.
    MeSH term(s) Aged ; Antipsychotic Agents/administration & dosage ; Antipsychotic Agents/adverse effects ; Antipsychotic Agents/therapeutic use ; Dementia/diagnosis ; Dementia/psychology ; Dibenzothiazepines/administration & dosage ; Dibenzothiazepines/adverse effects ; Dibenzothiazepines/therapeutic use ; Drug Administration Schedule ; Drug Tolerance ; Female ; Humans ; Male ; Psychotic Disorders/diagnosis ; Psychotic Disorders/drug therapy ; Psychotic Disorders/etiology ; Quetiapine Fumarate ; Severity of Illness Index
    Chemical Substances Antipsychotic Agents ; Dibenzothiazepines ; Quetiapine Fumarate (2S3PL1B6UJ)
    Language English
    Publishing date 2006-01
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1283069-0
    ISSN 1938-2731 ; 1533-3175 ; 0895-5336 ; 1082-5207
    ISSN (online) 1938-2731
    ISSN 1533-3175 ; 0895-5336 ; 1082-5207
    DOI 10.1177/1533317506294775
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Role of lormetazepam in the treatment of insomnia in the elderly.

    De Vanna, Maurizio / Rubiera, Marta / Onor, Maria Luisa / Aguglia, Eugenio

    Clinical drug investigation

    2007  Volume 27, Issue 5, Page(s) 325–332

    Abstract: Background and objective: Sleep architecture changes with age, both in terms of efficiency and total duration of sleep. Hypnotic benzodiazepines promote rapid onset of sleep, uninterrupted sleep and longer duration of sleep in the absence of carryover ... ...

    Abstract Background and objective: Sleep architecture changes with age, both in terms of efficiency and total duration of sleep. Hypnotic benzodiazepines promote rapid onset of sleep, uninterrupted sleep and longer duration of sleep in the absence of carryover sedation the following morning; therefore, these may be appropriate for use in older patients. This study was performed to evaluate the efficacy and safety of lormetazepam in elderly patients with primary insomnia when used in association with sleep hygiene training (SHT). The impact of restored sleep on daily sleepiness was also investigated.
    Patients and methods: In this open-label study, 30 elderly outpatients with insomnia were randomised to receive 2 weeks of treatment with lormetazepam 0.5mg + SHT or SHT alone, followed by a 1-week observation period. Details on sleep latency, number of awakenings and freshness on awakening were recorded by patients in a daily sleep diary. The Epworth Sleepiness Scale (ESS) and Stanford Sleepiness Scale (SSS) were used to measure daily sleepiness.
    Results: Addition of lormetazepam to SHT improved all sleep parameters measured compared with SHT alone. Mean duration of sleep improved significantly from baseline (mean rank=1.00) in the lormetazepam + SHT group after 2 weeks of treatment (mean rank 2.87; Friedmann test=27.448; p<0.001), but declined significantly in the group receiving SHT alone (from mean rank 2.33 to 1.57; Friedmann test=6.465; p<0.05). Mean duration of sleep increased by approximately 150 minutes each night in the lormetazepam + SHT group but decreased by more than 30 minutes in the SHT-only group. Improvement in sleep quality from baseline was statistically significant only in the lormetazepam + SHT group: for both deepness of sleep and the perception of awakening refreshed, mean scores increased from approximately 3 at baseline to approximately 8 (on a scale of 1-10) after 2 weeks in this group. Sleep latency also decreased significantly in the lormetazepam + SHT group: after 2 weeks, on average patients were awakening less than once per night. SSS and ESS scores also improved significantly in the lormetazepam + SHT group; in contrast, in the SHT-only group, the mean ESS score worsened significantly from baseline and the mean SSS score remained relatively constant. No rebound insomnia was reported during follow-up in patients in the lormetazepam group. Vital signs did not change from baseline and no adverse events were reported for either group.
    Conclusion: Management of insomnia in the elderly appears to have a better outcome when pharmacotherapy is combined with SHT rather than SHT alone. The earlier improvement in sleep quality with lormetazepam when used in combination with a sleep training programme may help to maintain adherence to treatment.
    MeSH term(s) Aged ; Combined Modality Therapy ; Female ; Humans ; Hypnotics and Sedatives/therapeutic use ; Lorazepam/analogs & derivatives ; Lorazepam/therapeutic use ; Male ; Sleep ; Sleep Initiation and Maintenance Disorders/therapy
    Chemical Substances Hypnotics and Sedatives ; lormetazepam (GU56C842ZA) ; Lorazepam (O26FZP769L)
    Language English
    Publishing date 2007-02-09
    Publishing country New Zealand
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1220136-4
    ISSN 1179-1918 ; 1173-2563 ; 0114-2402
    ISSN (online) 1179-1918
    ISSN 1173-2563 ; 0114-2402
    DOI 10.2165/00044011-200727050-00003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2807: Show issues Location:
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  4. Article: Impact of a multimodal rehabilitative intervention on demented patients and their caregivers.

    Onor, Maria Luisa / Trevisiol, Marianna / Negro, Cecilia / Signorini, Alessandra / Saina, Marisa / Aguglia, Eugenio

    American journal of Alzheimer's disease and other dementias

    2007  Volume 22, Issue 4, Page(s) 261–272

    Abstract: Alzheimer's disease is becoming a social, political, and economic issue as a result of both the growing number of people affected and the enormous economic, social, and emotional costs involved in caring for Alzheimer's patients. The aim of this study is ...

    Abstract Alzheimer's disease is becoming a social, political, and economic issue as a result of both the growing number of people affected and the enormous economic, social, and emotional costs involved in caring for Alzheimer's patients. The aim of this study is to evaluate the effects of a multimodal intervention program for patients with Alzheimer's disease and their caregivers. The study was conducted on a sample of 32 subjects: 16 Alzheimer's patients and their caregivers. The results obtained after the multimodal rehabilitation program showed that the Alzheimer's patients had a more stable cognitive status and improved mood. Regarding the psychoeducational program, the results demonstrate the efficacy of such interventions in terms of increasing and preserving the caregivers' coping skills and enhancing their perception of the value of support groups.
    MeSH term(s) Aged ; Alzheimer Disease/diagnosis ; Alzheimer Disease/epidemiology ; Alzheimer Disease/rehabilitation ; Caregivers/education ; Cognition Disorders/diagnosis ; Cognition Disorders/epidemiology ; Cognition Disorders/rehabilitation ; Cognitive Behavioral Therapy/methods ; Depressive Disorder, Major/diagnosis ; Depressive Disorder, Major/epidemiology ; Depressive Disorder, Major/psychology ; Female ; Health Education ; Humans ; Male ; Neuropsychological Tests ; Personal Autonomy ; Program Development ; Surveys and Questionnaires
    Language English
    Publishing date 2007-06-29
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1283069-0
    ISSN 1938-2731 ; 1533-3175 ; 0895-5336 ; 1082-5207
    ISSN (online) 1938-2731
    ISSN 1533-3175 ; 0895-5336 ; 1082-5207
    DOI 10.1177/1533317507302071
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Clinical experience with risperidone in the treatment of behavioral and psychological symptoms of dementia.

    Onor, Maria Luisa / Saina, Marisa / Trevisiol, Marianna / Cristante, Tania / Aguglia, Eugenio

    Progress in neuro-psychopharmacology & biological psychiatry

    2007  Volume 31, Issue 1, Page(s) 205–209

    Abstract: Dementia is a neuropsychiatric disorder characterized by cognitive impairment and behavioral and psychological symptoms. The efficacy and tolerability of risperidone for treating dementia-associated psychological and behavioral disturbances were ... ...

    Abstract Dementia is a neuropsychiatric disorder characterized by cognitive impairment and behavioral and psychological symptoms. The efficacy and tolerability of risperidone for treating dementia-associated psychological and behavioral disturbances were evaluated in a study of 135 patients aged 60-85 years with DSM-IV diagnoses of Alzheimer's disease. All were treated with risperidone at a starting dose of 0.5 mg once daily at bedtime. After the first 3 days of therapy the dosage was increased to 1 mg in 2 doses (morning and evening), then a further 0.5 mg was added (alternatively in the morning and in the evening) every three days until attenuation of the psychiatric symptoms. The response to treatment was evaluated for a period of 12 weeks by the Neuropsychiatric Inventory (NPI) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Both NPI and BEHAVE-AD were administered at the baseline visit, and after 4 and 12 weeks of therapy. Tolerability was assessed by the incidence of clinically evident side effects. The mean dose at endpoint was 1 mg/day of risperidone. The mean NPI score was 28.80+/-13.92 at start, 15.55+/-11.25 after 4 weeks and 8.30+/-7.00 at endpoint. The reduction in mean scores at 4 and 12 weeks was statistically significant in most of the Neuropsychiatric Inventory items, except for appetite disorders (p<0.0001). The mean BEHAVE-AD score was 20.44+/-3.92 at start, 13.50+/-11.39 after 4 weeks and 8.03+/-7.80 at endpoint. All the items showed a statistically significant improvement after 4 and 12 weeks (p<0.0001). The results were better at 12 than at 4 weeks. In our elderly patients with dementia low-dose risperidone was well tolerated and associated with reductions in BPSD, in particular agitation, aggression, irritability, delusions, sleep disorders, anxiety and phobias.
    MeSH term(s) Aged ; Aged, 80 and over ; Alzheimer Disease/drug therapy ; Alzheimer Disease/psychology ; Antipsychotic Agents/administration & dosage ; Antipsychotic Agents/adverse effects ; Antipsychotic Agents/therapeutic use ; Behavior/drug effects ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Psychiatric Status Rating Scales ; Risperidone/administration & dosage ; Risperidone/adverse effects ; Risperidone/therapeutic use
    Chemical Substances Antipsychotic Agents ; Risperidone (L6UH7ZF8HC)
    Language English
    Publishing date 2007-01-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 781181-0
    ISSN 1878-4216 ; 0278-5846
    ISSN (online) 1878-4216
    ISSN 0278-5846
    DOI 10.1016/j.pnpbp.2006.09.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Insight in persons with schizophrenia: effects of switching from conventional neuroleptics to atypical antipsychotics.

    Aguglia, Eugenio / De Vanna, Maurizio / Onor, Maria Luisa / Ferrara, Domenico

    Progress in neuro-psychopharmacology & biological psychiatry

    2002  Volume 26, Issue 7-8, Page(s) 1229–1233

    Abstract: The primary aim of our study is to evaluate the level of insight during the switch from a classical antipsychotic drug to a atypical neuroleptic. Twenty-two schizophrenic patients were admitted to the study, 9 were male and 13 were female. Standardized ... ...

    Abstract The primary aim of our study is to evaluate the level of insight during the switch from a classical antipsychotic drug to a atypical neuroleptic. Twenty-two schizophrenic patients were admitted to the study, 9 were male and 13 were female. Standardized questionnaire were: Scale for Assessment of Negative Symptoms (SANS), Scale for Assessment of Positive Symptoms (SAPS), Brief Psychiatric Rating Scale (BPRS) and Schedule for Assessing the three components of Insight (SAI). All patients were receiving haloperidol at time of recruitment. Eight patients were switched to clozapine, 3 to risperidone and 11 to olanzapine. The global function, measured with BPRS, increased after administration of atypical antipsychotics. The positive and negative symptoms were reduced. The level of insight was increased after the administration of the atypical antipsychotics. The cognitive effect of the atypical antipsychotics changed the level of insight and augmented the compliance.
    MeSH term(s) Adult ; Antipsychotic Agents/administration & dosage ; Antipsychotic Agents/pharmacology ; Benzodiazepines ; Clozapine/administration & dosage ; Clozapine/pharmacology ; Cognition/drug effects ; Cognition Disorders/chemically induced ; Cognition Disorders/prevention & control ; Female ; Haloperidol/administration & dosage ; Haloperidol/pharmacology ; Humans ; Male ; Olanzapine ; Patient Compliance ; Pirenzepine/administration & dosage ; Pirenzepine/analogs & derivatives ; Pirenzepine/pharmacology ; Risperidone/administration & dosage ; Risperidone/pharmacology ; Schizophrenia/drug therapy ; Schizophrenia/pathology ; Severity of Illness Index ; Treatment Outcome
    Chemical Substances Antipsychotic Agents ; Benzodiazepines (12794-10-4) ; Pirenzepine (3G0285N20N) ; Clozapine (J60AR2IKIC) ; Haloperidol (J6292F8L3D) ; Risperidone (L6UH7ZF8HC) ; Olanzapine (N7U69T4SZR)
    Language English
    Publishing date 2002-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 781181-0
    ISSN 1878-4216 ; 0278-5846
    ISSN (online) 1878-4216
    ISSN 0278-5846
    DOI 10.1016/s0278-5846(02)00242-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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