ChEI treatment

ChEI treatments have been expanded also to include other dementias and CNS disorders, e.g. delirium, traumatic brain injuries and memory impairments, as well as myasthenia gravis, glaucoma and parasite infections. 

Parkinson s disease (PD) patients may suffer cognitive and behavioural impairments including apathy, personality changes and visual hallucinations, with no currently recommended treatment. Their significant cholinergic deficits led to recommendation of ChEI therapeutics. 

Delirium, e.g. post-narcotic delirium, somnolence or coma, is a common complication involving dementia, with fluctuating attention and consciousness and considerable morbidity. It is not always reversible and there is no specific treatment. Some of the accompanying central cholinergic syndromes can be reversed by ChEIs. 

Treatment should be initiated in order to attenuate the symptoms which impair the patient s quality of life or which jeopardize them or those around. It should be ensured that the patient receives specific treatment for their disease (ChEIs and/or memantine). 

FIGURE 11—54. Cognitive symptom pharmacy. Atypical antipsychotic dmgs (SDA) may improve cognitive functions in both schizophrenic and Alzheimer patients (first-line treatment). They may boost the actions of cholinesterase inhibitors (ChEIs) in Alzheimer s disease. It may also be useful to discontinue any anticholinergic medication that you can, a welcome bonus when switching from conventional antipsychotics to atypical antipsychotics (decreased A Ch). 

Combined use of ChEI with neuroleptic and antidepressant medication Although the successes of most pharmacological treatments for autistic adults are limited, combining medications may prove to be more effective. A study by Wang et al., 2007 examined the synergistic effect of risperidone and galantamine on the phencyclidine-induced mouse model of schizophrenia. Similar to autism, schizophrenic patients suffer from cognitive defects and impaired memory function. 

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