Abstract:
:Atypical antipsychotics are commonly used off-label to treat behavioural and psychiatric symptoms in dementia (BPSD), particularly in elderly care homes. Much of this use is inappropriate, and trials have shown an increased likelihood of serious cerebrovascular adverse events (CVAEs) such as stroke and transient ischemic attack (TIA) in elderly patients. The aetiology of this risk is not known, but may be related to metabolic effects and excess weight gain. Based on a review of published trials with risperidone and olanzapine that shows a three-fold increase in stroke risk in elderly patients with dementia, regulators in Europe and the USA now recommend against using these agents for behavioural control, particularly in patients with a history of cerebrovascular disease. When making prescribing decisions, physicians should pay careful attention to risk versus benefit with psychotropics. Antipsychotics should be regarded only as rescue medications for acute-onset (over hours or days) or for severe chronic BPSD, or used in patients who are aggressive and/or represent a danger to themselves or others. If atypical antipsychotics are prescribed, physicians should screen for risk factors for both stroke and cardiovascular disease when initiating treatment, and regular monitoring should be undertaken if patients with chronic behavioural problems receive antipsychotic maintenance therapy. International guidelines are now required that direct prescribers in the appropriate use of alternative therapies for BPSD. Cholinesterase inhibitors (ChEIs), particularly rivastigmine, can delay the onset and reduce the severity of neuropsychiatric symptoms in dementia, and decrease the requirement for antipsychotic and other psychotropic medications. Evidence suggests that they may be more appropriate for the control of chronic (over weeks to months) mild-to-moderate BPSD.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Bullock Rdoi
10.1185/030079904x16777keywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
1-10issue
1eissn
0300-7995issn
1473-4877journal_volume
21pub_type
杂志文章,评审abstract:OBJECTIVE:To determine the effects of long-term atomoxetine treatment on sexual development in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) as compared with placebo and with a national US survey in non-Hispanic white children and adolescents. METHODS:This double-blind, placebo-controll...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2011.599372
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:GOAL (Gauging Osteoarthritis [OA] with Limbrel*), an open-label, post-marketing study was performed to determine the overall efficacy and gastrointestinal (GI) tolerability of flavocoxid, a novel, plant-based, anti-inflammatory medication, in a 'real world' clinical practice setting. To this end, the study e...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/03007991003694522
更新日期:2010-05-01 00:00:00
abstract::A single-blind, open-label controlled study was carried out in 30 healthy male volunteers to compare gastro-intestinal blood loss before, during and after treatment with a new, sustained-release formulation of the non-steroidal anti-inflammatory agent etodolac (etodolac SR) or with naproxen. Subjects remained at the s...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007999209115217
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:Sulfonylurea therapy among patients with type 2 diabetes mellitus (T2DM) can be disrupted due to adverse events, including hypoglycemia. A retrospective study using the MarketScan claims database quantified the frequency of sulfonylurea discontinuation or down-titration and identified associated risk factors...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2016.1190325
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Lowering intraocular pressure (IOP) is currently the only therapeutic approach that preserves visual function in primary open-angle glaucoma. In making treatment decisions for first- and second-line therapy, the clinician needs to provide an appropriate balance of efficacy and tolerability. Prostaglandin ana...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2011.613923
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:It has been postulated that intraocular pressure, an important glaucoma risk factor, correlates positively with arterial blood pressure (blood pressure). However, results of experimental and clinical studies are often contradictory. It is hypothesized that, in some hypertensive patients, disturbances in intr...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1080/03007995.2017.1415203
更新日期:2018-03-01 00:00:00
abstract::Objective: To examine the potential sociodemographic disparities in type 2 diabetes (T2D) management and care among US adult individuals, after controlling for clinical and behavioral factors.Methods: This was a retrospective cohort study of individuals with T2D (N = 4552) from a linked database of the National Health...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1756764
更新日期:2020-06-01 00:00:00
abstract::Objective: To review the mechanism of action, pharmacology, dosing, and complications of tranexamic acid (TXA) and consolidate current evidence for TXA in gynecologic surgery.Methods: A literature search of PubMed, Ovid (MEDLINE), Google Scholar, and Elsevier was performed, in addition to a targeted search of cited re...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1080/03007995.2019.1708533
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Physicians and other health care personnel rely on the peer-reviewed biomedical literature as a key source for making clinical decisions. Thus, ensuring that the nonclinical and clinical findings published in biomedical journals are reported accurately and clearly, without undue influence from commercial int...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007990802646584
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To investigate the efficacy of the cholesterol absorption inhibitor ezetimibe in patients with refractory familial hyperlipidaemia or intolerant to statin therapy. METHODS:This prospective study assessed the safety and efficacy of ezetimibe in 200 patients with refractory familial hyperlipidaemias not achiev...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/030079905X28872
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:Pharmaceutical preparations of human menopausal gonadotrophin (hMG), urine-derived follicle-stimulating hormone (u-FSH) and highly purified u-FSH (u-FSH-HP) have been available since the early 1960s and the mid 1980s and 1990s, respectively. Another commercial preparation of u-FSH-HP, Folyrmon P, was launched...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079905X48410
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:Subcutaneous immunotherapy (SCIT) for allergic rhinitis (AR) has been shown to control symptoms for up to several years following treatment discontinuation, but the effect of SCIT on healthcare costs for commercially insured patients is unknown. The objective of this study was to compare healthcare costs and ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1359517
更新日期:2017-11-01 00:00:00
abstract::Cholinesterase inhibitors, which act by inhibiting the degradation of acetylcholine in the brain, form the mainstay of therapy for AD. Predominant adverse events are cholinergic in nature, the most frequent being gastrointestinal side effects. Here we present a case series of patients with dementia who were treated wi...
journal_title:Current medical research and opinion
pub_type: 信件
doi:10.1185/030079906X162791
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Evaluation of the safety and efficacy of insulin detemir (IDet) in the observational and non-interventional PREDICTIVE study. METHODS:A total of 2923 patients with type 1 or 2 diabetes on basal-bolus regimens were followed for 6 months: Group (1) NPH + human insulin (HI) bolus switching to IDet + analogue bo...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007990903262885
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To assess the impact of the decision by Kela (The Social Insurance Institution) to adopt guidelines for the management of food allergies in children, developed by the Finnish Medical Society Duodecim, as the basis for reimbursing clinical nutrition preparations for the treatment of cow milk allergy (CMA) in F...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079908x280455
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:Modern immunology has been extremely successful in elucidating many features of the immune system, but not in stemming pandemics of non-infectious, immune-related disease associated with industrialized populations. These pandemics involve a broad range of allergic, autoimmune, and inflammatory diseases, poten...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2012.695731
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To systematically identify and assess current quality measures for anticoagulation in atrial fibrillation (AF), venous thromboembolism (VTE) treatment and surgical VTE prophylaxis. RESEARCH DESIGN AND METHODS:Fifteen quality measure websites were searched as were bibliographic databases (January 2000-Februar...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2016.1200020
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:Neurogenic bladder refers to morphofunctional alterations of the bladder-sphincter complex secondary to central or peripheral neurological lesions. Discal etiology can be suggested by clinical observation in patients complaining of classical lower back pain, but not excluded even without musculoskeletal pain....
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2013.807788
更新日期:2013-08-01 00:00:00
abstract::Faecal blood loss arising from tenoxicam at a dose of 20 mg/day was compared to that arising from piroxicam at a dose of 20 mg/day in a double-blind, parallel comparative study in 12 healthy male volunteers. Faecal blood loss was measured for a 1-week run-in on placebo, during 4 weeks of treatment and for a 2-week pos...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998509109629
更新日期:1985-01-01 00:00:00
abstract:INTRODUCTION:Detection of β-thalassemia trait or carriers (β-TT) depends significantly on an increase in Hemoglobin A2 (HbA2) levels, which is found at low levels (<3%) in normal healthy individuals and elevated levels (≥3.5%) in β-TT individuals. The study was designed to evaluate the reliability of the diagnostic par...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2018.1435520
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:There are contrasting positions concerning the benefit-risk ratio of acetaminophen use for osteoarthritis (OA)-related pain. To clarify the effectiveness of acetaminophen or acetaminophen-codeine combinations according to their regimen of use, we evaluated whether being a regular user (adherent) of these medi...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1308920
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:This meta-analysis compared the median overall survival (mOS) of brentuximab vedotin reported in the pivotal phase 2 study with published results of other therapies for the treatment of relapsed/refractory (R/R) Hodgkin lymphoma (HL) post autologous stem cell transplant (ASCT). RESEARCH DESIGN AND METHODS:A ...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/03007995.2015.1048208
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To quantify changes in clinical and cost outcomes associated with increasing levels of body mass index (BMI) in a US setting. RESEARCH METHODS AND PROCEDURES:A semi-Markov model was developed to project and compare life expectancy (LE), quality-adjusted life expectancy (QALE) and direct medical costs associa...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079906X96227
更新日期:2006-03-01 00:00:00
abstract::A double-blind, crossover study was carried out in 31 patients with rheumatoid arthritis or osteoarthritis who suffered from insomnia which was considered to be caused primarily by their disease. Patients received 7-day courses of 400 mg chlormezanone, 200 mg chlormezanone and placebo in a pre-determined random order....
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998309109782
更新日期:1983-01-01 00:00:00
abstract:UNLABELLED:Abstract Background: The Schizophrenia Trial of Aripiprazole (STAR) showed superior efficacy for aripiprazole compared with atypical antipsychotic standard-of-care (SOC) for the community treatment of schizophrenia 1 based on the Investigator Assessment Questionnaire total score. OBJECTIVE:To determine the ...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2010.542745
更新日期:2011-02-01 00:00:00
abstract::An open, multi-centre study was carried out in 117 pregnant women presenting with vaginal candidosis to assess the effectiveness of econazole in providing mycological control and symptom relief, and in preventing, as far as possible, the risk of contamination of the newborn: nearly 50% of the patients were in the last...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007998509109606
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:In controlled clinical trials, rabeprazole effectively improves symptoms and heals oesophageal erosions in patients with gastro-oesophageal reflux disease (GORD). AIM:To examine symptom relief during week 1 of rabeprazole therapy, in addition to GORD healing, in a clinical practice setting. METHODS:In this...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1185/030079905X41444
更新日期:2005-04-01 00:00:00
abstract::The potential advantages of eletriptan lie firstly in its lipophilicity reflected as an increased rate of absorption and Tmax compared to sumatriptan. This is manifested in a modest advantage over sumatriptan in terms of speed of onset, 2 h headache response and 2 h pain free. However, eletriptan has not yet been show...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/0300799039117004
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy and safety of lumiracoxib for knee osteoarthritis (OA). METHODS:This was a 13-week, multicentre, randomized, double-blind, double-dummy, placebo-controlled study. Males or females aged >/= 18 years with primary knee OA received lumiracoxib 100 mg od, lumiracoxib 100 mg od with a loa...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/030079905x38196
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:In this study, we explored the analgesic and antihyperalgesic properties of a synthetic cannabinoid (nabilone) on experimental heat pain in men and women, as well as its effects on descending pain inhibitory systems. RESEARCH DESIGN AND METHODS:A double-blind, placebo controlled, crossover study of nabilone ...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/030079908x280635
更新日期:2008-04-01 00:00:00