Senile and Presenile Dementia: Further Observations on the Benefits of a Dicumarol‐Psychotherapy Regimen

Abstract

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.

Presenile Dementia: Further Experience with an Anticoagulant‐Psychotherapy Regimen*

“…Presenile dementia seems primarily to result from cerebrovascular insufficiency and this insufficiency often can be prevented and even reversed by anticoagulant therapy (1). Further experience with the treatment of senile and presenile dementias (2, 3) has confirmed our earlier hypothesis presented in 1967 (4) that both disorders have a common etiology (insufficient blood supply to the brain) and both can respond to anticoagulant therapy (5). My psychiatric training led to awareness that complex and serious emotional factors also are involved in the clinical picture as observed in medical practice.…”

“…Individual psychotherapy and family therapy can be very effective in helping the patient and the family to cope with these aspects of the problem while the anticoagulant therapy is exerting its effect (3). Many of these patients are under severe emotional stresses which may have precipitated the cerebral circulatory insufficiency, in the same way that emotional stress may trigger anginal attacks.…”

Alcohol and Reduced Cerebral Blood Flow

“…This possibility is further born out by the good results we have obtained in many cases of senility using anticoagulant therapy to reduce the sludging of blood 3,4 . The patients with brain damage from alcohol are more likely to improve than the usual senility patients, probably because most of their damage was due to the alcohol causing aggregation of the red blood cells 5…”

Hypochondriasis Associated with Organic Brain Syndrome: A New Approach to Therapy

“…These complaints included abdominal or retrosternal discomfort, obsession about constipation, visual difficulties, minor skin lesions such as a simple wart, and sometimes intractable pain (in the back, chest wall or elsewhere). Almost invariably these troublesome symptoms cleared when the psychotherapy‐anticoagulant regimen (3) for OBS took effect. This happened so regularly as to lead to two assumptions with new patients: 1) if they had a longstanding hypochondriacal complaint, it represented another factor in favor of the diagnosis of brain damage; and 2) if they received adequate therapy, the complaint would almost certainly disappear within two or three months.…”