sign in sign up
<<
Home , Quetiapine

CurePSP is committed to providing its CurePSP is the leading nonprofit organization constituents—patients, families, caregivers, working to improve awareness, education, care, and and healthcare providers—with up-to-date cure for devastating prime of life neurodegenerative educational information about living with diseases. These include progressive supranuclear PSP and related diseases. palsy (PSP), corticobasal degeneration (CBD), multiple system atrophy (MSA), and others. Neurodegenerative diseases involve They often strike when people have careers, family multiple physical and motor changes, responsibilities, and active lives. Their symptoms but equally important are the emotional, are incapacitating, and there are no known causes, behavioral, and cognitive effects of these treatments, or cures. diseases. The purpose of this pamphlet is to help you navigate the process of Research has shown that there are important links seeking evaluation and treatment of between prime of life diseases and more common psychiatric symptoms and to understand neurodegenerative conditions, such as Alzheimer’s disease and Parkinson’s disease. Your support will the potential benefits and side effects of help advance this research, provide resources for medications for those symptoms. families and caregivers of patients, and better educate The facts and suggestions contained here the healthcare community. Together, we are unlock- are general guidelines intended to inform ing the secrets of brain disease. your discussions with your healthcare CurePSP is a not-for-profit 501(c)(3) organization. provider and not as prescriptions to Gifts and pledges of support are encouraged, and stand on their own. Any treatment plan donations are tax deductible to the extent allowed must consider the specific medical, by law. Understanding psychological, and social situation of the patient and should not operate on the Use of a “cookbook” basis. Psychotropic Medications 1216 Broadway 2nd Floor with Neurodegenerative New York, NY 10001 347-294-2873 (CURE) Diseases such as PSP, www.curepsp.org [email protected] CBD, and MSA Facebook.com/curepsp.foundation

©2020 CurePSP, Inc. CurePSP, Unlocking the Secrets of Brain Disease, and Because Hope Matters are registered trademarks of CurePSP, Inc. THE NEED FOR A GOOD NEUROBEHAVIORAL ISSUES AND should be avoided. In some cases, this effect can interfere Memory: For memory problems, the medications PSYCHIATRIC EVALUATION MEDICATION SUGGESTIONS with swallowing and with the ability to cough. A common prescribed are commonly those used with example is Haldol (generic: ), which is often Alzheimer’s disease: Aricept (donepezil), Exelon Neurological care needs to be multifaceted and Depression: The best approach to treating depression is administered in hospitals and skilled nursing facilities to (rivastigmine), and Reminyl (galantamine). While include combinations of medications, physical therapy a combination of counseling, , physical treat the agitation and hallucinations that can occur when these may be worth a two-month trial, they have not or exercise, emotional support, speech and swallow and mental exercise, support, social outlets, and routine. a person with cognitive loss is moved to an unfamiliar, been shown to help the cognitive or memory loss therapy, occupational therapy, socialization, positive With PSP, MSA, and CBD, the medications that are stressful environment. Other common in people with PSP, CBD, or MSA. They can cause attitude, family involvement, hobbies and interests, typically prescribed for depression are the selective medications that people with any sort of parkinsonian sedation and can speed up the action of the and more. Optimal symptom control may also require reuptake inhibitors (SSRIs) and the serotonin- disorder should avoid include Zyprexa (), gastrointestinal and urinary systems, causing such psychiatric medications. The issue of such medication reuptake inhibitors (SNRIs). In addition, Vraylar (), Saphris (), side effects as bloating, gas, diarrhea, drooling, and is particularly complex and requires the expertise of a (TCA)—whose side effect can Latuda (), Geodon (), urinary frequency/urgency. a neurologist, psychiatrist, or neuropsychologist who be dry mouth—may decrease drooling while helping with Risperdal (), Abilify (), understands and can differentiate among the wide depression. Low Blood Pressure Warning: Prolixin (), Thorazine (), selection of medicines: those that have the best chance An important feature of MSA is low blood pressure, The antidepressants that are NOT indicated are Moban (), Trilafon (), of working with the least side effects. which can cause dizziness and even fainting. Many narcotics, especially those with codeine derivatives like Triavil (perphenazine and ), of the antipsychotic and anti-anxiety drugs can If you have the advantage of receiving your care from oxycodone, which is a component of Percocet. Navane (thiothixene) and Mellaril (). themselves reduce blood pressure. Therefore, people a specialist who sees many patients like yourself, then Anxiety: Many anti-anxiety medications— with MSA should be prescribed such medications you may experience less of a struggle with this question. Even the recommended antipsychotic drugs have side —cause drowsiness, confusion, lethargy, with care. Most such clinicians work in academic medical centers. effects. The goal of treatment with is the and/or imbalance, and can affect memory, especially in balance between motor symptom control and the THE TAKE-AWAY MESSAGE: We hope older people. Therefore, anti-anxiety drugs should be used Some neurologists are experienced and comfortable management of . that these ideas and suggestions provide taking care of psychiatric issues in their patients with with caution. Antidepressants like SSRIs and SNRIs have Impulsivity: you with directions and options as you an anti-anxiety effect and are more advisable choices. For problems with control, anti- neurological disorders. If you feel that you would consider the often-complicated matter of (discussed above) are often prescribed, benefit from an additional opinion from a psychiatrist Hallucinations, Delusions, Agitation: Many of the availing yourself of psychiatric evaluation though clear data supporting that use is not available. or neuropsychologist, ask your neurologist or primary drugs to treat these symptoms fall into the category of and treatment. Remember to talk with your Another type of drug sometimes used for impulsivity are care provider to refer you to one. antipsychotics. In this classification, two drugs are neurologist about any emotional, behavioral, mood stabilizers like Depakote (valproic acid) and and cognitive changes you are experiencing. typically recommended: Clozaril (generic name, Tegretol (), again, without hard data for Together, you and your doctor will assess the ) and Seroquel (quetiapine). Of the two, PSP, CBD, and MSA. changes, look for possible triggers, review all quetiapine has the more sedating effect and therefore is your medications and perhaps medication often prescribed at nighttime. Clozapine’s potential to A special type of impulsivity is uncontrolled bursts of changes, and come up with a treatment plan laughing or crying, called “emotional incontinence” or damage the bone marrow requires weekly blood tests that may or may not demonstrate the need “pseudobulbar affect (PBA).” This occurs in a significant and some paperwork and is far less widely prescribed for psychotropic medication. than quetiapine. minority of people with PSP and some other disorders. A drug combination called Neudexta ( Many other antipsychotics worsen the parkinsonian Co-written by Lawrence I. Golbe, MD and ) has been approved for treating people motor symptoms such as slowness and stiffness and and Diane Breslow, MSW, LCSW, July 2019 whose PBA proves disabling or embarrassing.