This report contains follow-up data on the effects of an anticoagulant-psychotherapy regimen in presenile and senile dementia. Over a two-year period, 49 such patients who were seriously ill were treated with a Coumadin-psychotherapy regimen; 34 (69 percent) improved (4 of them dramatically) and 15 (31 percent) did not improve or became worse. The underlying pathologic processes are discussed, with the rationale for therapy.
Research data from many sources appear to confirm the theory that circulatory insufficiency of the brain plays a major role in the development of senile and presenile dementia. This insufficiency is probably caused most frequently by sclerotic narrowing of the arteries supplying the brain combined with blood sludging or thrombosis in the arteries, capillaries or veins. Experience gained thus far from therapeutic trials in a small number of patients indicates that progression of the dementia can usually be arrested at once by the use of bishydroxycoumarin (Dicumarol). In some patients there has been worthwhile improvement in mental status. These findings suggest that for many patients, early treatment wih Dicumarol may prevent progressive mental deterioration, and thus put senile dementia in the category of a preventable disease.
This study began seven years ago in an attempt to assess the effect of anticoagulant (Dicumarol) therapy in senile or presenile dementia or organic brain syndrome due to arteriosclerosis. The present regimen consists of an initial two‐month trial of Dicumarol. The patient's prothrombin time is used as a guideline for stabilizing the dosage. Concomitant intensive psychotherapy recently has been added during the initial two‐month period. The improved patient is then referred to his local physician for maintenance anticoagulant therapy. All 22 patients in the present series improved, 8 markedly.
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