Treatment of behavioral problems with pindolol

Greendyke, Robert M.; Berkner, J; Webster, Jeni; Gulya, Aladar

doi:10.1097/00001199-198912000-00016

Cited by 2 publications

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“…[151][152][153][154][155][156] While methodological problems, including crossover designs, small numbers and mixed age samples, limit interpretation of results, approximately 67% of patients appear to respond. 157 Specific contraindications for the use of beta blockers include congestive heart failure and chronic obstructive pulmonary disease and adverse effects include bradycardia and hypotension (possibly with lesser frequency when using pindolol).…”

Section: Beta Blockersmentioning

confidence: 99%

Recommendations for the Management of Behavioral and Psychological Symptoms of Dementia

Herrmann

2001

Can. J. Neurol. Sci.

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Suppl. 1 -S96 serious problem that they encountered, rating it more frequently as a serious problem than the memory disturbance itself. The significance of BPSD was recently endorsed by both the United States A l z h e i m e r's A s s o c i a t i o n 6 and the International Psychogeriatric Association 1 as research priorities. The phenomenology and prevalence of BPSD have beenThe behavioral and psychological symptoms of dementia (BPSD) include delusions, hallucinations, misidentifications, agitation, wandering, pacing, restlessness, disinhibition, apathy, negativism, emotional lability, depression, anxiety, sleep disturbance and sexually inappropriate behaviours.1 While not included as diagnostic criteria for dementia by DSM-IV 2 or the NINCDS-ADRDA, 3 behaviours such as paranoia, depression, euphoria and apathy were recognized by Alzheimer in the initial description of the illness that bears his name. 4 Historically, the focus on BPSD began only recently, prompted by an early study by Rabins et al,5 who interviewed caregivers of patients with dementia. While these behaviours were noted in 50-90% of patients, caregivers considered physical aggression the most ABSTRACT: Background: The behavioral and psychological symptoms of dementia (BPSD) are common, serious problems that impair the quality of life for both patient and caregiver. In order to provide recommendations based upon the best available evidence, a qualitative literature review was performed. Methods: A search of the English language medical literature published between 1966 and 2000 was performed. The quality of the studies was assessed by considering the subjects, trial design, analysis and results. Final recommendations were based upon the quality of available evidence. Results: The management of BPSD begins with a thorough assessment to search for underlying causes of behaviour change. Concomitant medical illness should be treated and sensory impairment ameliorated. Nonpharmacological approaches should be instituted prior to medication use. These interventions include music, light, changes in level of stimulation and specific behavioral techniques. Antipsychotics are the best studied pharmacological intervention for agitation and aggression and have demonstrated modest but consistent efficacy. Antidepressants such as trazodone and selective serotonin re-uptake inhibitors, as well as anticonvulsants such as carbamazepine and valproic acid have also demonstrated efficacy. Benzodiazepines can be used for short-term treatment as p.r.n. agents when necessary. Pharmacotherapy must be monitored closely for both effectiveness and side effects, with consideration of medication withdrawal when appropriate. Conclusion: The management of BPSD can significantly improve the quality of life for the patient and caregiver. Their assessment and management are essential components of the treatment of dementia.RÉSUMÉ: Recommandations pour la prise en charge des symptômes comportementaux et psychologiques de la démence. Introduction: L e s symptômes comportementaux et ...

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Section: Beta Blockersmentioning

confidence: 99%

Recommendations for the Management of Behavioral and Psychological Symptoms of Dementia

Herrmann

2001

Can. J. Neurol. Sci.

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“…Undoubtedly there is extensive clinical experience on the part of individual clinicians with the use of these medications. Indeed, one author (Greendyke et al, 1989) reported treating over 100 patients with pindolol. In our clinics trazodone and carbamazepine are prescribed frequently in preference or subsequent to a neuroleptic.…”

Section: Serotonin Uptake Inhibitorsmentioning

confidence: 99%

Non‐neuroleptic medications in the management of agitation in Alzheimer's disease and other dementia: A selective review

Schneider

Sobin

1991

Int J Geriat Psychiatry

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SUMMARYBoth neuroleptic and non-neuroleptic medications are widely used to treat symptomatic behaviors in dementia patients. There is a substantial body of literature suggesting that neuroleptics are modestly effective in treating these symptoms, but the magnitude of their effect is limited. Non-neuroleptic medications such as anticonvulsants and antidepressants have been advocated as useful in treating certain symptoms but have not been as well studied. This article critically reviews the published evidence for the effectiveness of selected non-neuroleptic medications in treating behavioral symptoms in elderly dementia patients, especially those with possible Alzheimer's disease. The medications reviewed include lithium, b-adrenergic blockers, trazodone, carbamazepine, buspirone, 1-deprenyl, and serotonin uptake blockers, reflecting the point of view that pharmacological approaches to the problem of agitation in dementia have included a variety of psychotropic medications. Most of these medications were not tried specifically with Alzheimer's disease patients, however, but in patients with various organic mental syndromes. The literature consists almost entirely of clinical series and case reports, making interpretations of the efficacy of individual medications difficult. With the singular exception of the serotonin uptake blocker citalopram, the few placebo-controlled studies are of small sample sizes, showing at best very modest efficacy for the study medication. Despite their widespread use, there is very little published empirical evidence for the effectiveness of these novel treatments for treating behavioral symptoms in elderly dementia patients.KEY worms-Agitation, dementia, management, non-neuroleptic medications.Agitation and other symptomatic behaviors remain principal problems in the clinical management of elderly patients with Alzheimer's disease and other dementia. Disruptive symptoms such as agitation, outbursts, violence, sleep disturbance, motor restlessness, delusion, hallucinations and misidentifications each occur in approximately one-third of various AD patient samples, with the majority of patients showing at least one symptom (Leuchter and Spar, 1985;Mayeux et al., 1985a;Reisberg et al., 1987). Between 50 and 75% of AD patients show significant disruptive behavior at some time during their illness (Rovner et al., 1990;Rubin, 1987).The consequences of agitated behaviors in dementia patients-regardless of the etiology-

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Treatment of behavioral problems with pindolol

Cited by 2 publications

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Recommendations for the Management of Behavioral and Psychological Symptoms of Dementia

Recommendations for the Management of Behavioral and Psychological Symptoms of Dementia

Non‐neuroleptic medications in the management of agitation in Alzheimer's disease and other dementia: A selective review

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