Cognitive disturbances

Hamilton Depression Scale. The HAMD is one of the most widely used tests to evaluate the severity of depressive illness quantitatively in adults. The most widely used form of this test contains 21 items covering a broad range of symptomatology, with a three- to five-point scale for most items. The minimum time required to complete this test is usually 10 to 20 minutes, and it requires a skilled interviewer. Either the present time or the period within the last week is rated. Six subscales are obtained in the HAMD anxiety/somatization, weight, cognitive disturbance, diurnal variation, retardation, and sleep disturbance. 

Frontotemporal dementias are characterized by gross structural changes in the frontal and anterior temporal lobes, metabolic disturbances, and involvement of certain subcortical structures as well (Ishii et al. 1998). Whereas in Alzheimer s disease the early cognitive disturbances are in memory, in frontotemporal dementias the early manifestations are in executive and behavioral function (Pfeffer et al. 1999 Varma et al. 1999). This relative cognitive distinction persists throughout the course of the two disorders (Pachana et al. 1996). Disinhibition and disorganization are common, and psychotic symptoms may be prominent in frontotemporal dementia. 

Meguro K, Yamaguchi S, Arai H, Nakagawa T, Doi C, Yamada M, Ikarashi Y, Maruyama Y, Sasaki H. (1994). Nicotine improves cognitive disturbance in senescence-accelerated mice. Pharmacol Biochem Behav. 49(3) 769-72. 

Maruyama Y, Matsuzaki Y, Ikarashi Y, Sekizawa K, Sasaki H, Yamaguchi S, Meguro K. (1992) Vitamin B12 improves cognitive disturbance in rodents fed a choline-deficient diet. Pharmacol Biochem Behav 43 635-639. 

According to Lenox and Manji (1998) the cognitive effects of lithium appear to be some of the most problematic for patients, yet they remain the least studied . A number of earl) observational studies were concerned with the question of whether lithium, which is normally administered for months or years, leads to detectable cognitive disturbance, particularly memory impairment. A starting point for these studies was the observation that many patients treated with lithium complained of being mentally slower, less attentive and also more forgetful than they used to be before they were put on lithium. 

Nicotine is a potent nerve poison, and is included in many insecticide preparations. In lower concentrations, nicotine is a stimulant, i.e. it increases activity, alertness and memory, and this is one of the main factors that contribute to the dependence-forming properties of tobacco smoking. Nicotine increases heart-rate and blood pressure, and reduces appetite. In higher doses, nicotine acts as a depressant. In large doses, it can cause nausea and vomiting. The main symptoms of the withdrawal of nicotine intake include irritability, headaches, anxiety, cognitive disturbances and sleep disruption. 

Future combination chemotherapies for disorders associated with cognitive disturbance and memory loss. Just as in the case of schizophrenia (as discussed in Chapter 11 on... 

This deficit causes some of the cognitive disturbances observed in the patient with Alzheimer s disease. 

King, D. J. 1994, Psychomotor impairment and cognitive disturbances induced by neuroleptics, Acta Psychiatr.Scand.Suppl., vol. 380, pp. 53-58. 

Clinical features I. Neurotoxicity a) Communication disturbances None or minimally b) Cognition disturbances None or minimally... 

Freedman BJ. 1974. The subjective experience of perceptual and cognitive disturbances in schizophrenia. Arch Gen Psychiatry 30 333-340. 

Risperidone has also been used in combination with topiramate in a Spanish multicenter study in 58 patients (28 men and 30 women mean age 41 years) with bipolar I disorder, with manic but not mixed episodes (20). Risperidone (mean dose 2.7 mg/day) and topiramate (mean dose 236 mg/day) were started with a maximum 48-hour time difference risperidone was used for acute manic symptoms and topiramate for longer-term stabilization and prevention of relapse. The incidence of any adverse event was 64%, mostly somnolence, paresthesia, dizziness, tremor, weight loss (n = 27 mean change -1.1 kg), extrapyramidal disorders, gastrointestinal effects, and cognitive disturbances. One patient developed tardive dyskinesia during the study and there were five dropouts because of adverse effects adverse effects that required withdrawal of risperidone but not topiramate were amenorrhea (n = 3) and sexual dysfunction (n = 1). 

Non-cognitive disturbances are common in patients with vascular cognitive impairment, with high rates of depression and apathy, particularly in those with small vessel disease. For example, in the Cache County Study, significantly more participants with vascular dementia (32%) than Alzheimer s disease (20%) suffered from depression, the reverse being true for... 

The major cognitive disturbances in schizophrenia may result from a deficit of myelination in relevant neuronal structures, such as the corpus callosum, involved in connectivity between both hemispheres the resulting decrease of electrical conduction in fiber tracks linking different parts of the brain may affect behavior and perception (Haroutunian and Davis, 2007 Haroutunian et al., 2007). 

Some off-label uses for cognitive disturbances other than Alzheimer disease have anecdotally utilized doses higher than 10 mg/day... 

Reichenberg A, Yirmiya R, Schuld A, aus T, Haack M, Morag A, Pollmacher T (2001) Cytokme-associated emotional and cognitive disturbances in humans. Arch Gen Psychiatry 58 445 52. 

Whether elderly patients taking lithium received proper monitoring was questioned in a case note audit of 91 patients, over 40% of whom had deviations from practice standards. These included absence of pretreatment laboratory tests, infrequent monitoring of serum lithium concentrations, lack of adequate adverse effects documentation, and the use of risky concomitant drugs (403). In a placebo-controlled study, there was poor tolerance of hthium augmentation of antidepressants in 76% (13/17) of elderly (mean age 70 years) patients at a mean serum concentration of 0.63 mmol/1, due to tremor and muscle twitches, cognitive disturbance, tiredness and sedation, and gastrointestinal upsets (404). 

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