Effects of sodium valproate on behavioral disturbances in elderly outpatients with dementia

Hatanaka, Kimitaka; Ishii, Terumi; Iwakiri, Masahiko; Sodeyama, Noriko; Tanaka, Yoshiro; Asada, Takashi

doi:10.1111/j.1447-0594.2010.00634.x

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…For example, serotonergic treatment with citalopram in the Citalopram for Agitation in AD study [ 99 , 100 ] observed significant improvement on outcome measures of agitation that was clinically meaningful on a global functioning scale compared with those who received placebo, whereas studies of dopamine augmentation [ 101 ] with medication such as amantadine have shown some modest treatment effects [ 102 ]. Use of atypical anti-psychotic medications (see above) as well as anti-epileptic mood stabilizers such as valproic acid [ 103 - 105 ] has become a mainstay in the treatment of these behaviors but similarly carries considerable risk.…”

Section: Management Of Common Neuropsychiatric Syndromes In Alzheimermentioning

confidence: 99%

Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia

2015

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Neuropsychiatric symptoms of Alzheimer’s disease (NPS-AD) are highly prevalent and lead to poor medical and functional outcomes. In spite of the burdensome nature of NPS-AD, we are continuing to refine the nosology and only beginning to understand the underlying pathophysiology. Cluster analyses have frequently identified three to five subsyndromes of NPS-AD: behavioral dysfunction (for example, agitation/aggressiveness), psychosis (for example, delusions and hallucinations), and mood disturbance (for example, depression or apathy). Recent neurobiological studies have used new neuroimaging techniques to elucidate behaviorally relevant circuits and networks associated with these subsyndromes. Several fronto-subcortical circuits, cortico-cortical networks, and neurotransmitter systems have been proposed as regions and mechanisms underlying NPS-AD. Common to most of these subsyndromes is the broad overlap of regions associated with the salience network (anterior cingulate and insula), mood regulation (amygdala), and motivated behavior (frontal cortex). Treatment strategies for dysregulated mood syndromes (depression and apathy) have primarily targeted serotonergic mechanisms with antidepressants or dopaminergic mechanisms with psychostimulants. Psychotic symptoms have largely been targeted with anti-psychotic medications despite controversial risk/benefit tradeoffs. Management of behavioral dyscontrol, including agitation and aggression in AD, has encompassed a wide range of psychoactive medications as well as non-pharmacological approaches. Developing rational therapeutic approaches for NPS-AD will require a firmer understanding of the underlying etiology in order to improve nosology as well as provide the empirical evidence necessary to overcome regulatory and funding challenges to further study these debilitating symptoms.

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Section: Management Of Common Neuropsychiatric Syndromes In Alzheimermentioning

confidence: 99%

Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia

2015

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“…However, those psychotropic drugs are associated with high levels of adverse drug reactions, such as falls and pneumonia (Ballard et al 2009;Gills et al 2007;Akihisa et al 2011). Psychotropic drugs are even sometimes used to treat ordinary memory loss, stress-induced insomnia (Assantachai et al 2011) and depression (Mizukami et al 2010). The use of such drugs to provide "dementia treatment" might cause cognitive function to be considerably reduced, in some cases down to zero (Azumi, et al 2011).…”

Section: Behavioral Psychological Symptoms Of Caregiversmentioning

confidence: 99%

New Lessons of Nurturing Life for Geriatric Patients

Butler

Fujii²,

Sasaki³

2012

Tohoku J. Exp. Med.

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Our new lessons of nurturing life to make happiness and well-being of geriatric patients suggest comprise several important steps. First, geriatric patient care should not be delegated to specialists who focus on individual organ system. Instead, we should respond to the patient's condition based on comprehensive assessment to identify the single pathogenesis. Second, we should appreciate that the behavioral and psychological symptoms of dementia (BPSD) often reflect the behavioral and psychological symptoms of the caregiver (BPSC), and in particular the caregiver's attitude. Third, pleasant stimulations to the limbic system should receive more emphasis than attempting brain training in atrophied portions of the neocortex. Fourth, we should aim not for "successful aging," but for "balanced aging." Fifth, we should rely less on drug-based therapy and utilize more non-pharmacologic approaches to appropriate therapy. Geriatric patients should be cared for based on our new lessons of nurturing life rather than the heavily medicalized treatment modalities that are in wide use today.

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“…VPA promoted neurogenesis and GSK-3β dependent neurite outgrowth in a mouse model of Alzheimer’s disease [ 47 , 48 ]. Therefore, VPA may be useful for the treatment of behavioral disturbance in dementia patients [ 49 , 50 , 51 , 52 ]. Parkinson’s disease is a progressive neurodegenerative disorder that primarily affects the motor control system.…”

Section: Discussionmentioning

confidence: 99%

Differential Expression of Multiple Disease-Related Protein Groups Induced by Valproic Acid in Human SH-SY5Y Neuroblastoma Cells

Chung

Ping

et al. 2020

Brain Sciences

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Valproic acid (VPA) is a multifunctional medication used for the treatment of epilepsy, mania associated with bipolar disorder, and migraine. The pharmacological effects of VPA involve a variety of neurotransmitter and cell signaling systems, but the molecular mechanisms underlying its clinical efficacy is to date largely unknown. In this study, we used the isobaric tags for relative and absolute quantitation shotgun proteomic analysis to screen differentially expressed proteins in VPA-treated SH-SY5Y cells. We identified changes in the expression levels of multiple proteins involved in Alzheimer’s disease, Parkinson’s disease, chromatin remodeling, controlling gene expression via the vitamin D receptor, ribosome biogenesis, ubiquitin-mediated proteolysis, and the mitochondrial oxidative phosphorylation and electron transport chain. Our data indicate that VPA may modulate the differential expression of proteins involved in mitochondrial function and vitamin D receptor-mediated chromatin transcriptional regulation and proteins implicated in the pathogenesis of neurodegenerative diseases.

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Effects of sodium valproate on behavioral disturbances in elderly outpatients with dementia

Cited by 8 publications

References 19 publications

Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia

Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia

New Lessons of Nurturing Life for Geriatric Patients

Differential Expression of Multiple Disease-Related Protein Groups Induced by Valproic Acid in Human SH-SY5Y Neuroblastoma Cells

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