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Dementia, Parkinson’s Disease (PD), and depression are intricate health concerns with accessible medicines for managing their symptom. In this discussion, we will discover dementia treatment, behavioral problems in dementia patients, the role of Levodopa in PD, and the difference between Venlafaxine and tricyclic antidepressants (McFall et al., 2023).
Medication in Dementia and Their Adverse Effects
Dementia is a progressive neurological condition characterized by a decline in cognitive function, memory, and the ability to perform everyday tasks, often resulting from underlying conditions like Alzheimer’s. There is no treatment, but numerous medicines are available to manage its symptoms (McFall et al., 2023). Two primary classes of drugs used for treating dementia are Cholinesterase Inhibitors and N-methyl-d-aspartate (NMDA) receptor antagonists (Steven et al., 2023). One of the most recommended Cholinesterase Inhibitors is Donepezil, accessible by the trade name Aricept. Its generic name is Donepezil. Side effects of this drug include diarrhea, headaches, and nausea. However, more critical side effects can involve reduced heart rate or gastrointestinal bleeding (Steven et al., 2023).
The other class of drugs utilized to treat dementia patients is NMDA receptor antagonists, with Memantine as a frequently recommended medicine, labeled with the trade name Namenda. Its generic name is Memantine. Side effects of Memantine include lightheadedness, bewilderment, and headache. In several cases, patients can face more severe side effects, such as hallucinations or increased blood pressure. The medication selection and its side effects should be sensibly considered while consulting a medical expert (Steven et al., 2023).
Behavioral Disturbances in Dementia and Treatment
Dementia can result in numerous behavioral disturbances, which becomes challenging for patients as well as their caregivers (Ambrogio et al., 2019). Two major disturbances are anxiety and depression. Anxiety can be treated with medicines such as Risperidone, marketed by its trade name, i.e., Risperdal, and its generic name, Risperidone. However, it is significant to observe that Risperidone can cause side effects like weight gain, drowsiness, and an increased chance of stroke, specifically in aging patients (Ambrogio et al., 2019).
Depression is another major problem in dementia patients, and it can be treated with antidepressants such as Sertraline, sold under the trade name Zoloft and its generic name, Sertraline (Ambrogio et al., 2019). As Sertraline is commonly well-tolerated, common side effects include insomnia, nausea, and sexual dysfunction. Medication decisions for behavioral disturbances must be discussed with a medical facilitator, valuing the sole needs of patients and potential side effects (Ambrogio et al., 2019).
Levodopa in Parkinson’s Disease
Levodopa is a vital medicine for managing Parkinson’s disease, a neurodegenerative problem characterized by a deficiency of dopamine in the brain. Levodopa is changed into dopamine in the human brain, easing motor symptoms like rigidity, bradykinesia, and tremors (Beckers et al., 2022). It is frequently used in a mixture with Carbidopa, which stops the early breakdown of Levodopa in the bloodstream, enabling it to reach the brain and decreasing peripheral adverse effects (Beckers et al., 2022).
However, Levodopa also has several side effects. Patients undergoing Parkinson’s disease can experience adverse effects like vomiting or nausea, reduced blood pressure while standing up, irregular unintentional movements, and psychiatric disturbances such as hallucinations or confusion with lasting use (Beckers et al., 2022). These adverse effects necessitate careful monitoring and adjustment of medicine doses by a medical facilitator to acquire the optimal balance between symptom relief and side effect management.
Combination of Levodopa and Carbidopa
The combination of levodopa and carbidopa, often sold under the trade name Sinemet, is commonly prescribed in Parkinson’s disease treatment (Müller, 2020). Carbidopa is used alongside levodopa to enhance its effectiveness by preventing the breakdown of levodopa in the bloodstream before it reaches the brain. This allows for lower doses of levodopa, reducing the risk of nausea and other peripheral side effects. The combination therapy provides better control over motor symptoms and improves the overall quality of life for patients with Parkinson’s disease (Müller, 2020).
Other Drugs for Parkinson’s Disease
Besides Levodopa and Carbidopa, there are various other medicines utilized for treating Parkinson’s Disease (PD). These involve dopamine agonists such as Pramipexole and Ropinirole, which increase dopamine receptors in the human brain, Monoamine Oxidase-B (MAO-B) inhibitors such as Selegiline and Rasagiline that assist in preserving dopamine levels, and Anticholinergic agents such as trihexyphenidyl that can handle various symptoms (Nyholm & Jost, 2022). Some progressive treatments, like deep brain stimulation, can be utilized for some patients. The selection of medication depends on the patient’s symptoms and response to medication (Nyholm & Jost, 2022).
Venlafaxine VS. Tricyclic Antidepressants (TCAs)
Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) utilized to combat depression. It is unlike Tricyclic Antidepressants (TCAs) in its mechanism of action (Henrik Galust et al., 2023). As TCAs prevent the reuptake of Serotonin and Norepinephrine, venlafaxine has a more demanding action on these Neurotransmitters. This can result in fewer anticholinergic adverse effects, like dry mouth, constipation, and blurry vision, which are usual symptoms in TCAs (Henrik Galust et al., 2023).
However, venlafaxine also has its own set of side effects. People consuming venlafaxine can face side effects such as sleeplessness, nausea, and sexual dysfunction. Moreover, venlafaxine can cause high blood pressure, particularly at increased doses. People recommended to take venlafaxine must be observed for these side effects, and the selection of antidepressants must depend on the individuals’ needs and acceptability, with the intimate direction of a healthcare provider (Henrik Galust et al., 2023).
Medicines are significant in administering disorders such as dementia, PD, and depression. Cholinesterase inhibitors and NMDA receptor antagonists assist dementia patients, but adverse effects should be observed. The use of drugs such as Risperidone and Sertraline can cause behavioral problems. Levodopa is essential for medicating Parkinson’s, often mixed with carbidopa. Numerous other Parkinson’s drugs provide options. The selection between venlafaxine and tricyclic antidepressants relies on different aspects. However, discussions with medical experts are necessary for well-informed decisions.
Ambrogio, Martella, Odetti, & Monacelli. (2019). Behavioral disturbances in Dementia and beyond Time for a new conceptual frame? International Journal of Molecular Sciences, 20(15), 3647. https://doi.org/10.3390/ijms20153647
Beckers, M., Bloem, B. R., & Verbeek, M. M. (2022). Mechanisms of peripheral levodopa resistance in Parkinson’s disease. Npj Parkinson’s Disease, 8(1). https://doi.org/10.1038/s41531-022-00321-y
Henrik Galust, Hardin, J., Friedman, N. R., Seltzer, J., & Clark, R. F. (2023). QRS prolongation after seizure in a patient with venlafaxine overdose. The Journal of Emergency Medicine. https://doi.org/10.1016/j.jemermed.2023.07.003
McFall, G. P., Bohn, L., Gee, M., Drouin, S. M., Fah, H., Han, W., Li, L., Camicioli, R., & Dixon, R. A. (2023). Identifying key multi-modal predictors of incipient dementia in Parkinson’s disease: A machine learning analysis and Tree SHAP interpretation. Frontiers in Aging Neuroscience, 15. https://doi.org/10.3389/fnagi.2023.1124232
Müller, T. (2020). Pharmacokinetics and pharmacodynamics of levodopa/carbidopa therapies for Parkinson’s disease. Expert Opinion on Drug Metabolism & Toxicology, 16(5), 403–414. https://doi.org/10.1080/17425255.2020.1750596
Nyholm, D., & Jost, W. H. (2022). Levodopa–entacapone–carbidopa intestinal gel infusion in advanced Parkinson’s disease: Real-world experience and practical guidance. Therapeutic Advances in Neurological Disorders, 15. https://doi.org/10.1177/17562864221108018