Delusions Dementia

True. Excessive alcohol use can lead to serious damage to mental health. Depression, anxiety, delusions and negative changes in personality can occur. Korsakoff s psychosis occurs in some excessive users of alcohol. This form of dementia results in disorientation, loss of memory and lowered intellectual abilities. It is reversible in some sufferers through the administration of thiamine (vitamin Bj. 

Uncomplicated, with delirium, with delusions, and with depressed mood Dementia due to HIV disease Dementia due to head trauma Dementia due to Parkinson s disease Dementia due to Huntington s disease Dementia due to Pick s disease Dementia due to Creutzfeldt-Jakob disease Dementia due to a specific general medical condition (specify) Dementia that is substance-induced Dementia due to multiple etiologies Dementia not otherwise specified... 

Psychosis for demented patients usually takes the form of paranoid delusions. Demented patients may believe family members have turned against them, or they may misidentify their loved ones as intruders in their home. Although hallucinations are not listed in the DSM-IV criteria, they may also occur. When psychosis occurs in a demented patient, it is a serious problem. It is very distressful to the patient, makes it difficult (if not impossible) for family members to provide care, may lead to episodes of violence, and commonly leads patients to be hospitalized or placed in nursing homes. Fortunately, most patients with dementia do not develop delusions or other psychotic symptoms. 

Atypical antipsychotics may be helpful in managing the delusions and agitated behavior that can accompany dementia. These medications, include risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify), and olanzapine (Zyprexa). All antipsychotics, typical and atypical, appear to increase the risk of death in patients with dementia and psychosis. This appears as a warning in the package inserts of the newer drugs. A prudent approach is to discuss this risk with the caregiver, use the lowest effective dose, and monitor for effectiveness. 

Delusions/Psychosis. Demented patients who are acutely psychotic and agitated should be treated in much the same manner as demented patients with delirium. Low doses of a high potency conventional antipsychotic like haloperidol were once preferred. This was mainly because it can be given both orally and by injection. In recent years, the atypical antipsychotic ziprasidone, which is now also available in oral and injectable forms, has superseded haloperidol as the preferred agent when treating the acutely psychotic and agitated patient with dementia. As previously noted, ziprasidone affords the same tranquilizing benefit as haloperidol, it can now be administered via injection when necessary, and it avoids the problematic extrapyramidal symptoms of haloperidol to which patients with dementia are often keenly sensitive. 

Deficiency - Pellagra is a state of niacin deficiency characterized by dermatitis, diarrhea, and dementia (manifestations of mucous membranes, Gl system, and CNS). In severe cases, confusion, delusions, disorientation, and hallucinations may occur. 

In a population-based study, hallucinations had occurred in 16% and delusions in 5% of PD patients during the month prior to evaluation. These symptoms were more common in those with dementia (Aarsland, 1999a). In a recent study using more detailed assessment methods and also including minor forms consisting of a sensation of presence, a sideway passage or illusions, 40%... 

In a similar study, Petrie et al. (1982) studied the effectiveness of halo-peridol and loxapine in the same type of patients. The conclusion was that, although the improvement of the psychotic symptomatology was evident, the global improvement of life quality was not that evident. The authors suggested that the medication response in elderly patients with dementia and psychotic symptoms was much inferior to the one observed in young patients with schizophrenia. R. Barnes et al. (1982) carried out a similarly designed study and found an improvement in only one-third of the treated patients. However, that sample was oriented not only to psychotic symptoms (delusions and hallucinations) but also to disruptive behaviors in general. 

The presence of delusions may lead to an erroneous diagnosis of schizophrenia in younger patients or of dementia with paranoia in the elderly. Nihilistic... 

More recently, 206 nursing home patients with moderate to severe Alzheimer s dementia with behavior disturbances or psychosis were randomly assigned to either placebo or a fixed dose of olanzapine at 5, 10, or 15 mg per day for up to 6 weeks of treatment ( 285). In this multicenter, double-blind, placebo-controlled study, olanzapine was significantly more efficacious than placebo in reducing psychosis and behavioral disturbances. The best result was obtained with the 5-mg dose in patients who did not have delusions or hallucinations. Although these patients were selected because of behavioral disturbance, hallucinations, or delusions, 75% did not have hallucinations at baseline, 43% did not have delusions at baseline, and 38% did not have psychosis at baseline. At end point, of those patients without hallucinations at baseline, hallucinations developed in 7.4% on olanzapine, compared with 21.9% on placebo ( p = 0.045). For those without delusions, 17% of placebo patients and 4% of olanzapine patients experienced delusions. For those subjects without psychosis (i.e., neither hallucinations nor delusions), psychosis developed in 8% of olanzapine patients and 25% of placebo patients (p = 0.006). Thus, olanzapine also seemed to prevent the occurrence of psychotic symptoms as the disease progressed. 

Some maintain that rather than treating a disease or condition, neuroleptics often create another disease. Although these drugs eliminate or reduce the intensity of psychotic experiences such as delusions and hallucinations, the adverse side effects that may actually worsen the symptoms of dementia. 

People with dementia may at some point in their illness develop symptoms such as depression, restlessness, aggressive behaviour and psychosis (delusions and... 

Several symptoms of dementia can be improved by risperidone. In 18 patients with Alzheimer s disease (no sex or age data reported), delusions of theft, hallucinations, and agitation/aggression improved significantly after 12 weeks of treatment (22). The modal optimal dosage was 1 mg/day, the same already suggested for this pathology (SEDA-26, 64). There were mild extrapyramidal symptoms at some point during the trial in one patient. 

Treats behavioral and psychological symptoms of Alzheimer dementia as well as cognitive symptoms (i.e., especially apathy, disinhibition, delusions, anxiety, cooperation, pacing)... 

May decrease delusions, apathy, agitation, and hallucinations in dementia with Lewy bodies... 

Agitation, which may occur in patients with dementia, can be treated with anti-psycho tics agents, mood stabilizing anticonvulsants, trazadone and anxiolytics (Doody et al., 2001). The atypical anti-psychotic medications are the treatment of choice for psychotic symptoms, such as hallucinations or delusions, particularly in those with Parkinsonism in whom dopamine receptor blockage is contraindicated due to the potential to worsen motor symptoms. In these patients, clozapine, which may reduce tremor in addition to its anti-psychotic effects, is particularly effective. However, rare cases of agranulocystosis necessitate weekly blood counts, and so limit its utility. Que-tiapine may be the next agent of choice because it appears to have fewer adverse motor effects than the other medications... 

Volatile solvent abuse or glue sniffing, is common among teenagers, especially males. The success of the modem chemical industry provides easy access to these substances as adhesives, dry cleaners, air fresheners, deodorants, aerosols and other products. Various techniques of administration are employed viscous products may be inhaled from a plastic bag, liquids from a handkerchief or plastic bottle. The immediate euphoriant and excitatory effects are replaced by confusion, hallucinations and delusions as the dose is increased. Chronic abusers, notably of toluene, develop peripheral neuropathy, cerebellar disease and dementia damage to the kidney, liver, heart and limgs also occurs with solvents. Over 50% of deaths from the practice follow cardiac arrhythmia, probably caused by sensitisation of the myocardium to catecholamines and by vagal inhibition... 

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