Cognition impaired

Benzodiazepines. Several BZs have anticonvulsant activity and ate used for the treatment of epilepsy producing their anticonvulsant actions via interactions with the GABA /BZ receptor complex to enhance inhibitory GABAergic transmission (1). The anticonvulsant actions of the BZs tend to tolerate upon chronic usage in six months, and BZs also lead to withdrawal symptomatology. Other side effects include sedation, ataxia, and cognitive impairment. 

Aniracetam (6), launched in 1993 in both Japan and Italy for the treatment of cognition disorders, is in Phase II trials in the United States as of this writing. In clinical studies it has been shown to cause some improvement in elderly patients with mild to moderate mental deterioration (63), and in geriatric patients with cerebral insufficiency (64). In a multicenter double-blind placebo-controUed trial involving 109 patients with probable AD, positive effects were observed in 36% of patients after six months of treatment (65), a result repeated in a separate study of 115 patients (66). A review of the biological and pharmacokinetic properties, and clinical results of aniracetam treatment in cognitively impaired individuals is available (49). 

Antiepileptics Na+, Ca2+ channels GABA receptors l Na+currents l Ca2+ currents GABA receptor activity l Excitability of peripheral and central neurons l Release of excitatory neurotransmitters Sedation, dizziness, cognitive impairment, ataxia, hepatotoxicity, thrombocytopenia... 

Dementia with Lewy bodies (DLB) is considered the second most common cause of dementia after AD. The disorder is characterized by progressive fluctuating cognitive impairment, visual hallucinations and motor features of Parkinsonism. Neocoitical cholinergic activity is more severely depleted in DLB than in AD, and DLB also affects the caudate nucleus, the thalamus and the brain stem. Tolerability of ChEI in DLB appears similar to AD, with some gastrointestinal effects and muscle cramps. 

Jonsson L, Lindgren P, Wimo A, Jonsson B, Winblad B (1999a). Costs of Mini Mental State Examination — related cognitive impairment. Pharmaeoeconomics 16, 409—16. 

Kavanagh S, Schneider J, Knapp M, Beecham J, Netten A (1993). Elderly people with cognitive impairment costing possible changes in the balance of care. Health Social Care 1, 69-80. 

Sacktor N, Nakasujja N, Skolasky R, Robertson K, Wong M, Musisi S, Ronald A, Katabira E (2006) Antiretroviral therapy improves cognitive impairment in HlV-l- individuals in sub-Saharan Africa. Neurology 67(2) 311-314... 

Phenobarbitone may be as effective as phenytoin and carbamazepine in partial and generalised tonic-clonic seizures but its other central effects such as sedation, depression, listlessness and cognitive impairment mar its usefulness. 

P = Psychological symptoms (anxiety, psychosis, cognitive impairment, depression)... 

Stage 1 No cognitive impairment No memory problems and no impairment is evident to a health care professional. 

Side effects associated with benzodiazepines in PD patients are similar to those observed in other disorders. Sedation, fatigue, and cognitive impairment are the most commonly reported side effects.49 Benzodiazepines should be avoided in patients with current substance abuse, a history of such, dependence, or sleep apnea. Additionally, caution should be used in older adults because they have more pronounced psychomotor and cognitive effects. 

Cognitive impairment (difficulty with recognition of the urinary urge and proper response to it)... 

Central nervous system disorder resulting in a decreased level of consciousness (see section on cognitive impairment)... 

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