Psychopharmacology and people with learning disability

Fraser, Bill

doi:10.1192/apt.5.6.471

Cited by 7 publications

(2 citation statements)

References 22 publications

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“…However, this is the case for many psychotropic agents, usually because learning disability is frequently an exclusion criterion for clinical trials (Fraser, 1999). The contraindications for acetylcholinesterase inhibitors are listed in Box 4.…”

Section: Treatment Of Dementia In Down's Syndromementioning

confidence: 99%

Down's syndrome and dementia

Stanton¹,

Coetzee²

2004

Adv. psychiatr. treat

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). Her research interests are in liaison in old age psychiatry, the interface between old age psychiatry and learning disability services, and neuropsychiatry. Rikus Coetzee is also a specialist registrar in general adult psychiatry and old age psychiatry at Duncan Macmillan House, Nottingham. His research interests are in the treatment and epidemiology of trauma-related neurosis in the elderly and the use of cognitive-behavioural therapy with elderly people. Down's syndrome and dementiaLisa R. Stanton & Rikus H. Coetzee Abstract Down's syndrome is the most common genetic disorder seen in clinical practice: about 94% occurs because of non-disjunction of chromosome 21 and 3-5% because of translocation. Individuals increasingly survive to middle and old age, probably because of advances in medical treatment and improved living conditions. People with Down's syndrome have an increased risk of developing Alzheimer's disease in middle age. Within ICD-10 and DSM-IV classifications there is no consensus on the diagnosis of dementia in people with learning disability. New treatments have been licensed for use in mild to moderate Alzheimer's disease (e.g. acetylcholinesterase inhibitors and memantine). The comorbid picture of Down's syndrome and Alzheimer's disease presents a unique challenge to the clinician in both diagnosis and management.

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Section: Treatment Of Dementia In Down's Syndromementioning

confidence: 99%

Down's syndrome and dementia

Stanton¹,

Coetzee²

2004

Adv. psychiatr. treat

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“…Chromosome 21 also encodes the gene for cytoplasmic superoxide dismutase (SOD). 37 There is some limited evidence that acetylcholinesterase inhibitors such as donepezil are of benefit in the management of Alzheimer's disease in Down's syndrome. 11 Mothers of people with Down's syndrome have been shown to be at higher risk themselves of developing Alzheimer's disease; this has led to the suggestion that Alzheimer's disease in Down's syndrome could be aetiologically related to early-onset familial Alzheimer's disease, which itself is associated with mutations in the genes for APP and presenilin 1 and 2.…”

Section: Down's Syndrome (Trisomy 21)mentioning

confidence: 99%

The mental health needs of older people with learning disability

Chance

2005

Rev. Clin. Gerontol.

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Donepezil for dementia in people with Down syndrome

Mohan¹,

Carpenter

Bennett

2009

Cochrane Database of Systematic Reviews

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To date there is only one small randomised controlled study on the effect of donepezil. This shows, at best, a modest, non statistically significant trend in favour of people with Down syndrome and Alzheimer's dementia who are able to tolerate donepezil (this drug is currently only dispensed in relatively large doses and is contraindicated for those with cardiac and respiratory problems).This study does not provide good evidence on which to base practice. Findings in an open-label follow up to this study suggest possible benefit in some individuals. Further, larger randomised controlled studies with longer-term follow up are required.

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Psychopharmacology and people with learning disability

Cited by 7 publications

References 22 publications

Down's syndrome and dementia

Down's syndrome and dementia

The mental health needs of older people with learning disability

Donepezil for dementia in people with Down syndrome

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