Podcasts about Memantine

In this episode, we explore the use of memantine in treating trichotillomania and skin picking disorder. Could this common Alzheimer's medication be the breakthrough we've been waiting for in managing body-focused repetitive behaviors? Dr. Bob Hudak discusses a promising study that offers new hope for patients struggling with these often-overlooked conditions. Faculty: Robert Hudak, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 60 Efficacy of Memantine in Treating Trichotillomania and Skin-Picking Disorder

On this episode of the Real Life Pharmacology Podcast, I cover 5 more medications of the top 200. Fenofibrate is a medication used primarily to reduce triglycerides. This medication differs from statins which tend to focus on LDL management. Doxazosin is an alpha-blocker. The primary indications of doxazosin are hypertension and BPH. Naproxen is an NSAID. Of all the NSAIDs, naproxen is one of the lower-risk agents with regard to cardiovascular risk. Spironolactone is an aldosterone antagonist and also classified as a potassium sparing diuretic. Memantine is an NMDA antagonist that is indicated for the management of Alzheimer's dementia. If you are looking for study materials and our list of popular Amazon books, check out meded101.com/store!

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-399 Overview: In this episode, we look at a new study showing increased probability of survival for patients with Alzheimer disease (AD) who take donepezil and memantine together. We review current treatments for AD and address common hesitations in prescribing dual pharmacotherapy, providing vital insights for primary care clinicians. Episode resource links: Yaghmaei, E., Lu, H., Ehwerhemuepha, L. et al. Combined use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer's disease patients.Commun Med 4, 99 (2024). https://doi.org/10.1038/s43856-024-00527-6 Guo J, Wang Z, Liu R, Huang Y, Zhang N, Zhang R. Memantine, Donepezil, or Combination Therapy-What is the best therapy for Alzheimer's Disease? A Network Meta-Analysis. Brain Behav. 2020 Nov;10(11):e01831. doi: 10.1002/brb3.1831. Epub 2020 Sep 10. PMID: 32914577; PMCID: PMC7667299. Guest: Jillian Joseph, MPAS, PA-C Music Credit: Richard Onorato Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-399 Overview: In this episode, we look at a new study showing increased probability of survival for patients with Alzheimer disease (AD) who take donepezil and memantine together. We review current treatments for AD and address common hesitations in prescribing dual pharmacotherapy, providing vital insights for primary care clinicians. Episode resource links: Yaghmaei, E., Lu, H., Ehwerhemuepha, L. et al. Combined use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer's disease patients.Commun Med 4, 99 (2024). https://doi.org/10.1038/s43856-024-00527-6 Guo J, Wang Z, Liu R, Huang Y, Zhang N, Zhang R. Memantine, Donepezil, or Combination Therapy-What is the best therapy for Alzheimer's Disease? A Network Meta-Analysis. Brain Behav. 2020 Nov;10(11):e01831. doi: 10.1002/brb3.1831. Epub 2020 Sep 10. PMID: 32914577; PMCID: PMC7667299. Guest: Jillian Joseph, MPAS, PA-C Music Credit: Richard Onorato Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

UV nail dryers cause DNA damage - with Dr. Julia Curtis! Cantharidin 0.7% for Molluscum - Imiquimod 5% cream for LM - TNF inhibitor induced Psoriasis - Memantine for Trichotillomania & Skin Picking - Check out our video content on YouTube: ⁠Dermasphere Podcast - YouTube⁠ - and VuMedi!: https://www.vumedi.com/channel/dermasphere/ The University of Utah's Dermatology ECHO: ⁠⁠https://physicians.utah.edu/echo/dermatology-primarycare - ⁠⁠Connect with us! - Web: ⁠https://dermaspherepodcast.com/⁠ - Twitter: @DermaspherePC - Instagram: dermaspherepodcast - Facebook: https://www.facebook.com/DermaspherePodcast/ - Check out Luke and Michelle's other podcast, SkinCast! ⁠https://healthcare.utah.edu/dermatology/skincast/⁠ Luke and Michelle report no significant conflicts of interest… BUT check out our friends at: - ⁠Kikoxp.com ⁠(a social platform for doctors to share knowledge) - ⁠https://www.levelex.com/games/top-derm⁠ (A free dermatology game to learn more dermatology!)

Drs John M. Kane and Mitchell Arnovitz discuss assessment of patients for negative symptoms of schizophrenia and the potential of MDMA in alleviating these symptoms in supervised treatment settings. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984490). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Schizophrenia https://emedicine.medscape.com/article/288259-overview MDMA for the Treatment of Negative Symptoms in Schizophrenia https://pubmed.ncbi.nlm.nih.gov/35743326/ MDMA (Ecstasy/Molly) https://nida.nih.gov/publications/drugfacts/mdma-ecstasymolly The NIMH-MATRICS Consensus Statement on Negative Symptoms https://pubmed.ncbi.nlm.nih.gov/16481659/ The Current Conceptualization of Negative Symptoms in Schizophrenia https://pubmed.ncbi.nlm.nih.gov/28127915/ Akinesia https://www.ncbi.nlm.nih.gov/books/NBK562177/ An Assessment of Five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) Commonly Used Symptoms Rating Scales in Schizophrenia and Comparison to Newer Scales (CAINS, BNSS) https://pubmed.ncbi.nlm.nih.gov/29430333/ Ecological Momentary Assessment https://pubmed.ncbi.nlm.nih.gov/18509902/ Schizophrenia Medication https://emedicine.medscape.com/article/288259-medication#2 Cariprazine, a Broad-Spectrum Antipsychotic for the Treatment of Schizophrenia: Pharmacology, Efficacy, and Safety https://pubmed.ncbi.nlm.nih.gov/34091867/ DRD3 Dopamine Receptor D3 [Homo sapiens (human)] https://www.ncbi.nlm.nih.gov/gene/1814 MDA https://dictionary.apa.org/mda Transcranial Magnetic Stimulation: A Review of Its Evolution and Current Applications https://pubmed.ncbi.nlm.nih.gov/31359968/ Memantine https://www.ncbi.nlm.nih.gov/books/NBK500025/ Making MDMA a Medicine (II) (Re)scheduling for Schedule I Substances https://maps.org/news/bulletin/making-mdma-a-medicine-ii-rescheduling-for-schedule-1-substances/ Vesicular Monoamine Transporter 2 (VMAT2) Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK548187/ Metaplasticity: Tuning Synapses and Networks for Plasticity https://pubmed.ncbi.nlm.nih.gov/18401345/ MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/34708874/ Reduction in Social Anxiety After MDMA-Assisted Psychotherapy With Autistic Adults: A Randomized, Double-Blind, Placebo-Controlled Pilot Study https://pubmed.ncbi.nlm.nih.gov/30196397/ Prefrontal Cortex-Nucleus Accumbens Interaction: In Vivo Modulation by Dopamine and Glutamate in the Prefrontal Cortex https://pubmed.ncbi.nlm.nih.gov/18508116/ Serotonin Syndrome https://emedicine.medscape.com/article/2500075-overview

What is the role of memantine in pediatric populations? This episode discusses memantine's potential indications and administration in children and adolescents, an explanation of the theory of glutamatergic dysregulation, and the evidence of memantine for ASD, OCD, and mood disorders. Faculty: David Rosenberg, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Atypical Psychopharmacologic Strategies for Children and Adolescents Memantine: Potential Indications in Children and Adolescents

Season 4, Episode 8

https://psychiatry.dev/wp-content/uploads/speaker/post-12091.mp3?cb=1677715124.mp3 Playback speed: 0.8x 1x 1.3x 1.6x 2x Download: Double-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder – Jon E Grant et al. American Journal of Psychiatry. 2023. TrichotillomaniaFull EntryDouble-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder –

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.10.10.511466v1?rss=1 Authors: Aiba, I., Ning, Y., Noebels, J. L. Abstract: Objective: Spreading depolarization (SD) is a massive wave of cellular depolarization that slowly migrates across brain gray matter. SD is frequently generated following brain injury and is associated with various acute and chronic neurological deficits. Here we report that spontaneous cortical SD waves are a common EEG abnormality in the Scn1a deficient mouse model (Scn1a+/R1407X). Method: Chronic DC-band EEG recording detected SDs, seizures, and seizure-SD complexes during prolonged monitoring in awake adult Scn1a+/R1407X mice. The effect of hyperthermic seizure and memantine was tested. Results: The spontaneous incidence of events is low and varied among animals, but SDs outnumber seizures. SD waves almost always spread unilaterally from parietal to frontal cortex. On average, spontaneous SD frequency robustly increased by 4.2-fold following a single hyperthermia-evoked seizure, persisting for days to a week without altering the kinetics of individual events. Combined video image and electromyogram analyses revealed that a single interictal SD is associated with prodromal motor activation followed by minutes-lasting immobility upon invasion of frontal cortex. Similar behavioral sequelae also appeared during postictal SD. Memantine treatment was effective in preventing SD exacerbation when given before and after the hyperthermic seizure, suggesting chronic activation of NMDA-receptor contributed to the prolonged SD aftermath. Interpretation: Our results reveal that cortical SD is a prominent electro-behavioral phenotype in this Scn1a deficient mouse model, and SD frequency is robustly sensitive to hyperthermic seizure induced mechanisms likely involving excess NMDAR signaling. The high susceptibility to SD may contribute to co-morbid pathophysiology in developmental epileptic encephalopathy. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:    Marilyn: In listening to your podcast about healing and sealing Leaky gut/SIBO, what is the name of the Lactobacillus strain that you suggest to start with? I can't quite understand what you said. I have been diagnosed with Leaky gut and possible SIBO but my functional doctor is wanting me to start with Probiotics and I get upper stomach pain from them.   Sandra: hi Dr. Cabral, love your work and I just finished the limited yeast protocol for high candida that came up on my big 5. I reintroduced all foods except for eggs. My migraines did not stop, and I want them gone – it makes me so hopeful that you say they do have a cure. My rain barrel must have filled up back in 2008 when painful migraines and hair loss/thinning started, and both have continued since. I am just fully looking into it after finding your work. For the last 6 years the migraines are mostly only in the nerves behind the eyes (eyes are healthy, no changes over time either) and mainly around the same time as my period, lasting 2-3 days. For 2 cycles, during the protocols, the migraine came a week after my period, that was the only change. I am working with a health coach and now focusing on heavy metal detox – mercury levels at 0.132. What else should I focus on? I think they are hormonal... and wonder if hair thinning can also be tied to hormones.   Emily: Hi Dr. Stephen, I really appreciate your guidance and advice. My just turned 8 year old son has been critically ill many times. He has severe brittle asthma, severe mucus plugging (has required high flow oxygen many times) and is highly allergic to many things, including being anaphylactic to antibiotics. I had a healthy pregnancy & he was born just after his due date, all natural birth & breast fed till he was over 12 months old. His siblings have no allergies or lung issues. He is currently undergoing allergy injections (2 injections every 4 weeks) for his rye grass, dust mites, moulds, and olive tree pollen allergies, we are 18months into this treatment which is set to continue for 3years. So far we have had no noticeable improvement from the injections. We have a farm in the South East of South Australia. He enjoys being active outside with his siblings and friends when he can. I am searching for help and advice. I am searching for answers as to why this is happening & what can be done to really help his lungs to strengthen & heal. I am struggling to get answers as to what is causing it all, from his specialists. Thank you so much for taking the time to read this. Kindest regards, Emily   Adele: Hello I am a 65 year old female, 5'2", 104, very active (walk, light weigh lifting (3-5 pounds), cycle classes, other gym classes. I suffer from daily chronic migraines. It is debilitating many days. After trying numerous preventive drugs - I now take "Memantine"(as of 3 months ago) which is for dementia patients - it is working fairly well right now.. Side effects are dizziness, low energy, head buzzing, etc. I plan to begin HRT again soon. should I? Other options for post menapausal issues? I have had 2 annual infusions of RECLAST past 2 summers. Osteoperosis same after that. They want me to take a 3rd infusion. Other issues are: severe osteoperosis, macular degeneration, neck and back pains. Supplements: (organic?) Vitamin D3 10,000IU, Calcium, Vitamin K, Magnesium, Fish Oil, I eat a fairly healthy diet - I ordered the 21 day Detox, food sensitivity test, Complete minerals and metals test. Any other recommendations? What is too much Vitamin D?   Alicja: Dr. Cabral, I need your wisdom again. I started checking my blood sugar and noticed it is always high. My glucose level first thing in the morning is always above 100 (between 105-115) I can't get it below 100, no matter how long I go without food. After eating it's between 130-180 depending what I ate. I listened to your older podcast and applied all 3 things you talked about. I eat 3 meals per day (3-4 house apart) I tried fasted jogging in the morning and I typically do intermittent fasting. glucose level is always above 100. I also noticed that if I go over 3h without food, the glucose level often rises up comparing to what was 2-3 h after meal. Do you think it's because not eating is too much stress on my body? I'm not typical candidate for diabetes. I'm tall and skinny, vata body type. I'm underweight (BMI below 16) I'm not sure if I have to give up carbs? Also does all that mean I'm insulin resistant? Or that I don't produce enough insulin? Thank you again for your help. Your big fan. Alicja   Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/2437 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!

What other medications can we offer to our patients with BPD? This episode discusses some novel medication approaches used in borderline personality disorder, including omega-3 fatty acids, methylphenidate, clonidine, doxazosin, memantine, and oxytocin.  Faculty: Paul Links, M.D.  Host: Jessica Diaz, M.D. Learn more about Premium Membership here Earn 0.5 CMEs: Pharmacologic Management of BPD: Recent Developments Omega-3 Fatty Acids, Methylphenidate, Clonidine, Doxazosin, Memantine, and Oxytocin for BPD

Dr. Don Marion and Dr. Anne Bunner discuss whether a drug known for treating Alzheimer's, which may have some neuroprotective effects, could improve short-term neurological function in patients with moderate TBI. Publication: Mokhtari, M., Nayeb-Aghaei, H., Kouchek, M., Miri, M.M., Goharani, R., Amoozandeh, A., Akhavan Salamat, S., Sistanizad, M. (2017). Effect of Memantine on Serum Levels of Neuron-Specific Enolase and on the Glasgow Coma Scale in Patients With Moderate Traumatic Brain Injury. Journal of Clinical Pharmacology. Epub ahead of print. doi: 10.1002/jcph.980 PubMed link: www.ncbi.nlm.nih.gov/pubmed/28724200 CUBIST is a podcast for health care providers produced by the Traumatic Brain Injury Center of Excellence. We discuss the latest research on traumatic brain injury (TBI) most relevant to patient care. For more about TBI, including clinical tools, go to www.health.mil/TBICoE or email us at dha.ncr.j-9.mbx.tbicoe-info@mail.mil. The views, opinions, and/or findings in this podcast are those of the host and subject matter experts. They should not be construed as an official Department of Defense position, policy, or decision unless designated by other official documentation. Our theme song is “Upbeat-Corporate' by WhiteCat, available and was used according to the Creative Commons Attribution-Noncommercial 4.0 license.

People living with dementia are prescribed different medications along the dementia journey. Two categories of medications are commonly prescribed at the beginning and middle of the journey: acetylcholinesterase inhibitors (like Aricept) and memantine. In this episode, I explain how these medications work, when they are usually prescribed, and if (or when) they can be stopped. WANT A FREE COPY OF MY NEW BOOK, MAKE DEMENTIA YOUR B*TCH? Enter the MDYB Podcast Challenge!!! rate and review my podcast on your favorite platform Email me a screenshot of your rating and review (rita.jablonski@gmail.com) Emails must be received by Friday, March 11 2022, 5 pm US Central time 3 winners will receive a signed copy of my book Winners will be announced during Episode 37 (which will be dropped Sunday, March 13, 2022) If you want to game the system and rate and review on multiple platforms, go for it! Meanwhile, check out my book, “Make Dementia Your B*tch! An Easy Guide to Understanding and Handling Dementia-driven Behaviors.” If you love my podcast, you will LOVE my book! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/rita-a-jablonski/message

Alberto Costa (Case Western Reserve University, Cleveland, OH, USA) discusses his study on the use of memantine in adolescents and young adults with Down syndrome, which is published in the January issue of The Lancet Neurology.Read the full article:https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(21)00369-0/fulltext

Well it was bound to happen eventually. After recording & editing episode 58 it was brought to my attention that memantine was already covered back in episode 19! I guess here is the new version? Sorry everybody. EPISODE #19 Summary: Memantine is a NMDA antagonist that goes by the brand name Namenda. There are also titration packs available in the name brand. Memantine treats but does not cure confusion and dementia associated with Alzheimer's disease. There are multiple dosage forms being a capsule, solution, and tablet. Special considerations are for patients with renal and hepatic impairment. Memantine does appear to have higher exposure in women than men. Memantine is proposed to work on the glutamate receptor blocking the receptor much like magnesium does under “normal” conditions. This drug has a long elimination half-life between 60-80 hours. The main side effects are weight gain, abdominal pain, constipation, diarrhea and vomiting. A serious side effect is Stevens Johnson Syndrome. Two main types of drugs that interact with Namenda are alkalinizing agents and carbonic anhydrase inhibitors. The drug can be taken with or without food and if a dose is missed it should not be doubled on the next dose. The missed dose should be skipped and resumed regularly. FREE Drug Card Sheet is available for this episode at DrugCardsDaily.com along with ALL past FREE drug card sheets! Please SUBSCRIBE, FOLLOW, and RATE on Spotify, Apple Podcasts, or wherever your favorite place to listen to podcasts are. I'd really appreciate hearing from you! Leave a voice message at anchor.fm/drugcardsdaily or find me on most all socials @drugcardsdaily or send an email to contact.drugcardsdaily@gmail.com to leave feedback, request a drug, or say hello! --- Send in a voice message: https://anchor.fm/drugcardsdaily/message

In this week's episode of the Spine & Nerve podcast Drs. Nicolas Karvelas and Brian Joves take a look back at basic physiology to try to look into the future. An area of research that has really piqued the interest of Dr. Karvelas in recent years has been the discussion/possibility of selective voltage gated sodium channel (NaV) modulators. NaV are transmembrane proteins that are an integral part of the initiation and propagation of action potentials in neurons and other electrically excitable cells. We have seen that small changes in NaV function are biologically relevant because there are several human diseases that are the result of mutations in these channels. This has led to research into selective NaV modulators as a potential target as we continue to search for treatment options with significant analgesic potential and decreased risk of side effects / adverse effects. The medical / research community continues to work to optimize medication options to treat painful disease processes. From an analgesic medication perspective, although there are a variety of different medications available including: topical medications, acetaminophen, non-steroidal anti-inflammatory drugs, gabapentin, pregabalin, serotonin norepinephrine reuptake inhibitors, tricyclic anti-depressant medications, non-selective sodium channel blockers, NMDA receptor modulations (Memantine, Ketamine), alpha-2 agonists, glial cell modulators (Low Dose Naltrexone), Buprenorphine, full mu opioids. These Medications are not without their limitations for multiple reasons including but not limited to side effects, risks, and contraindications depending on patient's age and/or comorbidities. To the best of our knowledge there are 10 different NaV subtypes; and specifically NaV 1.3, 1.7, 1.8, 1.9 have been demonstrated to play a critical role in pain signaling. NaV 1.8 is a sensory neuron specific channel with preferential expression in the dorsal root ganglion and trigeminal ganglion neurons, and it is highly expressed on nociceptors. Similar to the other NaV subtypes that have been identified to play essential roles in pain, mutations in NaV 1.8 have been demonstrated to lead to significant alterations in the nervous system / pain pathways; specifically gain of function NaV 1.8 mutations clinically manifest as painful small fiber peripheral polyneuropathy. NaV 1.8 modulation is being aggressively researched with the goal of positive impact on painful diseases. VX-150 is a oral pro-drug that is a highly selective inhibitor of NaV1.8, and a recent study by Dr. Hijma and colleagues was published evaluating the analgesic potential and safety of VX-150. Listen as the doctors discuss this exciting and important area of research. The discussion includes a detailed review of the fore-mentioned recent research article. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve. References: 1. Hijma HJ, Siebenga PS, de Kam ML, Groeneveld GJ. A Phase 1, Randomized, Double-Blind, Placebo-Controlled, Crossover Study to Evaluate the Pharmacodynamic Effects of VX-150, a Highly Selective NaV1.8 Inhibitor, in Healthy Male Adults. Pain Med. 2021 Aug 6;22(8):1814-1826.

Un nouvel épisode du Pharmascope est maintenant disponible et on termine notre série d'épisodes sur les troubles neurocognitifs majeurs. Dans ce 76ème épisode, Nicolas, Sébastien, Isabelle et leur invité discutent du traitement pharmacologique de la démence.  Les objectifs pour cet épisode sont: Expliquer les bénéfices et les risques associés aux traitements pharmacologiques des troubles neurocognitifsDiscuter du suivi de l'efficacité et de l'innocuité des traitements utilisés dans les troubles neurocognitifsComparer les avantages et inconvénients des différents agents utilisés dans le traitement des troubles neurocognitifs Ressources pertinentes en lien avec l'épisode Revues systématiquesBirks JS, Harvey RJ. Donepezil for dementia due to Alzheimer's disease. Cochrane Database Syst Rev. 2018;6:CD001190. Birks JS, Evans JG. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev. 2015;4:CD001191. McShane R et coll. Memantine for dementia. Cochrane Database Syst Rev. 2019;3:CD003154. Consensus canadien sur la démenceIsmail Z et coll. Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia. Alzheimers Dement. 2020;16:1182-95. Commission du LancetLivingston G et coll. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396:413-46. Documents de l'INESSSInstitut national d'excellence en santé et en services sociaux. Outils de repérage mesurant les fonctions cognitives, l'autonomie fonctionnelle et les symptômes comportementaux et psychologiques de la démence. 2015. Institut national d'excellence en santé et en services sociaux. Alzheimer - outils / activités. 2015.

Weekly news about COVID-19 infections and vaccine issues around the world; Chimeras of human and monkey embryos proved possible; A friend with Lupus getting dodgy advice needs a Functional Medicine solution; The use of the Alzeimers drug Memantine to treat a variety of central pain syndromes; Dr. Dawn favors Feverfew over Butterbur for migraine pain treatment; New suggestions for fibromyalgia pain -- old drugs like naltrexone used in new ways; Treating low iron lab results does not necessarily require infusion therapy; Warnings about Cannabis edibles that look like candy

Weekly news about COVID-19 infections and vaccine issues around the world; Chimeras of human and monkey embryos proved possible; A friend with Lupus getting dodgy advice needs a Functional Medicine solution; The use of the Alzeimers drug Memantine to treat a variety of central pain syndromes; Dr. Dawn favors Feverfew over Butterbur for migraine pain treatment; New suggestions for fibromyalgia pain -- old drugs like naltrexone used in new ways; Treating low iron lab results does not necessarily require infusion therapy; Warnings about Cannabis edibles that look like candy

NMDA antagonists are excellent additions to chronic pain management. Why would you choose either? How do they work and what evidence do we have? In this edition of our member podcast, Matt reviews the use of these drugs and how they can help your patients.

Early onset Alzheimer’s can be an enormously difficult diagnosis to come to terms with. Many people who are diagnosed are in the middle of a career, raising a family, and pursuing new ventures when this disease unexpectedly disrupts life as they know it.   New studies have found that an early diagnosis could lead to more positive experiences with treatment and there are ways to slow the rate of progression so patients can maintain a sense of normalcy for as long as possible.   Still, there is no cure for Alzheimer’s disease, so anyone who has received a diagnosis will have to re-evaluate many things in their life in order to best prepare for what’s to come.   On today’s episode of All Home Care Matters, we’ll be discussing all you need to know about early onset Alzheimer’s. We know how difficult this disease can be to face – so we want you to know that we are here to support you through the ups and downs of this new and trying journey.   This episode will be a little different. In addition to discussing what early onset Alzheimer’s is and how it affects the brain, what symptoms to look for and what options are for treatment, we’ll also talk about the tougher stuff. How to speak to your kids about a diagnosis. How to handle friends, family, and a possible stigma that you might face outside of your home. How to plan ahead financially and legally, while you’re still in the early stages of the disease.   We know that this is a diagnosis that interrupts your world. That’s why it’s so important to take the time to prepare for the future and implement a healthy lifestyle with a treatment plan. That way, you can focus on spending time with your family and taking on new and cherished experiences, instead of spending all of your time worrying and stuck in the dark about what comes next.   Many people with early on-set Alzheimer’s feel alone after a diagnosis. Watching friends and family continuing to live their lives, getting to focus solely on their careers and family, can cause a great deal of resentment and even depression.   One key difference, on an emotional level, between Alzheimer’s and early onset Alzheimer’s is that those experiencing the former are more likely to have peers in similar situations – whether friends, friends of friends, or a community in a senior living facility. For those with early onset, the world can feel like it’s coming to a halt for you and only you.   That’s why I want to start by saying this: even though it may not feel like it now, you are not alone. According to alz.org, it’s estimated that about 200,000 people in the United States have early onset. That’s 5% of the 5 million Americans living with Alzheimer’s.    If you are at all interested, in can be enormously helpful to meet others who are facing similar circumstances. There are support groups available for patients with the diagnosis as well as counseling services, gathering events, and more. Look into your local community to see what resources might be available to you. Surrounding yourself with others who know what you are going through could help you to feel supported, encouraged, and not alone.   Now, before we get any further, let’s get into the basics. When anyone under the age of 65 is diagnosed with Alzheimer’s disease, it’s considered early onset, or younger onset. A person can be in their thirties, forties, or fifties. More rarely, a person might get the disease as early as their twenties.   In the brain, early onset does not look different from standard Alzheimer’s. In both cases, the brain is no longer able to function normally because of nerve cell death and tissue loss caused by a build-up of protein fragment clusters between nerve cells. At the same time, a dead nerve cell contains tangles – or twisted protein strands.   The protein fragment clusters are known as plaques. When the plaques and tangles crowd the brain together, it caused mixed-up signaling that can trigger immune system cells, which consume the dead or dying cells and trigger inflammation.   In the end, the brain is unable to properly process nutrients or other important supplies. That leads to cell death. The dead cells tend to crowd in the areas of the brain that affect thinking, planning, learning, and memory. That’s why Alzheimer’s patients eventually lose their memory altogether. To learn more about how Alzheimer’s affects the brain, check out our episode on understanding Alzheimer’s and dementia.   While it is estimated that around 200,000 Americans are living with early onset, that number is likely even greater. The disease is often overlooked or misdiagnosed by doctors, who simply do not consider Alzheimer’s or dementia on their younger patients. Sometimes, a patient can get multiple misdiagnoses from multiple doctors before being diagnosed with early onset. This means that many people do not know they have the disease until they are already in the later stages.   If you believe you may have the disease, receiving a diagnosis can be a painful and disheartening process. That’s why it’s so important to advocate for yourself and push your doctors to evaluate you for early onset if you are suffering from memory problems.   If you are truly worried and your doctor is simply not considering early onset even after you specifically ask, make an appointment with an Alzheimer’s specialist. They are much more likely to give you comprehensive, conclusive evaluation. At the very least, they will help you to feel validated and comforted – which can mean the world after enough doctor appointments that felt like they were going nowhere.   It’s important to note that early onset is not something you can take a test for like strep throat or the flu. It can only be diagnosed after a careful and drawn-out medical evaluation, in which the doctor will ask you a series of questions about your symptoms, memory, and quality of life, before making a definite diagnosis. Remember to be honest with your answers and share anything memory related, even if you feel it isn’t relevant, because too much information is always better than not enough – especially when going after a diagnosis that is difficult to come by at a younger age.   There are two types of early onset Alzheimer’s. The first type is Common Alzheimer’s Disease, which is the most typical form among both early onset patients and patients 65 and older. This version of the disease progresses at much the same rate in younger patients as it does in older ones. Unfortunately, researchers have not yet determined what causes Common Alzheimer’s Disease, and there are no risk factors that might lead to the disease. Common Alzheimer’s early onset could happen to anyone.   The other type is early onset familial Alzheimer disease. This is much rarer. Patients with this type of Alzheimer’s usually have a parent or parents that have also had the disease. A patient’s siblings and children have a 50/50 chance of getting the disease themselves at an atypically young age. A person who has two parents with the disease is at a higher risk than someone who only has one parent with it.   Researchers have pinpointed two types of genes that influence a person’s likelihood to get familial Alzheimer’s disease. These are risk genes and deterministic genes.   If a person has risk genes, then they have an increased chance of developing the disease, but it is not guaranteed. Risk genes include APOE-e4, APOE-e2, and APOE-e3. Those with APOE-e4 have a 40-65% chance of eventually being diagnosed with Alzheimer’s. According to alz.org, about 2% of the US population has this gene.   Deterministic genes guarantee that a person will inherit Alzheimer’s. This type of gene is exceptionally rare – only a few hundred families have been found to pass it on worldwide. Deterministic genes lead to early onset Alzheimer’s for patients in the early 40’s to mid 50’s.   Sadly, early onset cases tend to progress more quickly than standard Alzheimer’s in older patients. This is because in patients with early onset, the plaque and tangle build up tends to be much larger. Alzheimer’s expert Dr. Thomas Wisniewski explained to CBS news in 2016 that, “the pathology tends to be more extreme in early-onset. Many can deteriorate more quickly, so it is a much more aggressive disease…when you look at the pathology, it’s just like late-onset Alzheimer’s disease, but there’s just more of it.”   This is the often-brutal reality for patients facing the early-onset form of this disease. However, because recent studies have found that early diagnosis can lead to better treatment options and a longer delay of progression, it’s essential that patients look for symptoms and report them to a doctor as soon as they notice any.   This is especially true for people whose parents or siblings have had Alzheimer’s or early-onset, but it is also true for anyone else, since there is no known cause for the majority of these cases.   Symptoms of early onset are quite similar to other versions of the disease. They include forgetting newly learned information, important dates, and even names of people close to them. If a person asks for information to be repeated multiple times on a semi-regular basis, this could be a sign. If a person is failing to remember something they used to know by heart – like a favorite recipe, hobby, or craft that they should be able to do with their eyes closed – that’s another sign. If a person is forgetting to pay their bills or stay on top of other important responsibilities, and gets confused and overwhelmed when they try, this is another sign.   Other symptoms include wandering or getting lost, forgetting how you got from one place to another, losing track of dates, forgetting important events, having trouble socializing, struggling to remember certain words in conversation, vision issues or depth perception issues, poor judgement, and slight mood and personality changes. In the later stages, symptoms include major mood swings and drastic changes to personality, increased paranoia – particularly surrounding close friends, family members, and caregivers – difficulty speaking and swallowing, mobility issues, and severe loss of memory.    If any number of these symptoms sound like you – don’t wait to book an appointment with an Alzheimer’s specialist. Again, the sooner you can get diagnosed, the better your options for treatment will be. Early diagnosis really is crucial to maintaining a normal quality of life for as long as possible.   While early onset Alzheimer’s does not have a cure, there are treatment options that can slow the progression of the disease and help patients maintain a good quality of life for longer than if no treatment was implemented.   Treatments usually consist of a mixture between medicines, physical activity, and healthy living. Common prescribed medications are Donepezil, Rivastigmine, Galantamine, and Memantine. Medicines can help a person for as long as months or even years, especially when combined with lifestyle changes.   Healthy lifestyle choices for patients with early onset are quite similar to those with standard Alzheimer’s disease. This means making a consistent effort to care for your physical, mental, and emotional wellbeing.   Alz.org recommends that patients find a physician that they truly trust and then build a relationship with them through regular check-ups. When your doctor is intimately familiar with your case, they will be more likely to notice any changes, even the subtle ones, that might require a change in treatment plan. At the same time, the more you trust your doctor, the more likely you are to call when you need guidance or have a medical related question.   You need to come up with a diet and exercise routine that will keep you moving, alert, and energized. The healthier and stronger your body is, the better equipped your mind will be to delay the progression of this disease. You can work with your doctor to establish a diet and exercise plan that best fits your individual needs.   There are also nutritionists, physical therapists, and personal trainers who specialize in Alzheimer’s patients. Be sure to work closely with an expert so you know that you are not over or under working yourself, and you are staying as healthy as possible.   All Alzheimer’s patients should drink less alcohol and more water and eat more fruits and vegetables and less junk food. When it comes to exercise, it’s usually recommended that patients engage in mild-to-moderate routines that will increase endorphins and help the body and mind without over-exerting the patient. According to alz.org, “physical activity may help delay or slow decline in thinking skills, reduce stress, possibly improve symptoms of depression, and may even reduce the risk of falls. Some evidence also suggests that exercise may directly benefit brain cells by increasing blood and oxygen flow. Even stronger evidence suggests exercise may protect brain health through its proven benefits to the cardiovascular system.”   The same site recommends trying exercises like aerobics, walking, biking, tennis, or even walking. Remember to consult your medical team before you engage in any exercise, though, because they will best know what you are capable of and what might help you the most.   In addition to diet and exercise, mental stimulation can play a big role in strengthening your brain and slowing cognitive decline. Try taking a class, picking up a new hobby, playing board games, or reading. Anything to stimulate your brain and get you thinking and problem solving is beneficial.   You also need to care for yourself emotionally. This is a diagnosis that can be devastating to live with, especially when you’re in the prime of your life, raising kids and engaging in a career. Early onset patients are liable to depression, anxiety, mood swings, and extreme feelings of loneliness. While you should certainly give yourself permission to feel whatever you need to during this difficult time, it is important to note that depression can actually lead to bigger health issues and even quicken the progression of your disease.   To help with these feelings, you have many options. You can join a support group for other patients with early onset so you can be part of a community that understands what you are going through. You can meet with a counselor or therapist regularly – especially one that specializes in Alzheimer’s and dementia. You can take time every day to do something you love, just for you. You can spend more time outside on walks, exercising, or just enjoying the fresh air. You can meet with trusted friends and family members and confide your fears and worries to them.   Early onset Alzheimer’s can hit so much harder when you are a parent in the middle of raising a family. Many early onset patients are young mothers and fathers who have to grapple with what their diagnosis will mean for their family. For some, this is the scariest part. No parent wants their child to go through grief, loss, or heartache of any kind – and to know that this disease will affect them can feel devastating. At the same time, many parents are left wondering if they will miss important milestones in their children’s lives or be able to be there for them as they grow up. Harboring these fears is a terrible thing for any parent to go through.   By caring for your physical and emotional needs, you will more likely be in a better place to care for your children longer and stay strong for them when you want to be. As hard as it might feel, do not neglect your own needs. The more you care for yourself, the better equipped you’ll be to care for your children.   Whether or not to talk to your child about your diagnosis will depend on a variety of factors – but ultimately, the decision is a deeply personal one that can only be made by you. How much you share might depend on your child’s age and what they are capable of digesting and understanding.   Children and teenagers alike might respond with a myriad of emotions. These can range from confusion, sadness, anger, curiosity, worry, guilt, embarrassment, or even jealousy as they are having to share their attention with their struggling parent. Teenagers in particular might withdraw from family and friends, have a hard time in school, stay away from home because it is too hard to see their parent suffer, avoid inviting friends over, and easily jump to anger or even aggression.   Remember that your child or teenager is grieving. This diagnosis means a loss of the way life used to be – and it is extremely heart wrenching for most children to watch their parents change and decline. Be patient with your child and give them space to feel how they need to.   There are many ways you can help your child to cope with this diagnosis and their changing lives. Offering patience, love, and support can mean everything. When your child knows they can go to you or their other parent or caretaker with their questions and their big feelings, then they are less likely to seek an outlet elsewhere.   It might help to arrange therapy or counseling for your child, or even group therapy for other kids who are going through the same thing. Just as building your own community is so beneficial, it will make children feel far less alone to know others can relate to them.   Provide your children with a space for their feelings – whether through art, music, or journaling. Educate them about the disease and what they can expect as time goes on, so they are not taken by surprise as the condition worsens. Be open and honest with them.   Family activities can also be enormously helpful, as they allow a child or teenager to hold onto a sense of family and stability – so they feel less lost and scared that they are losing their foundation. Activities can include walking, hiking, going to movies, playing or listening to music, playing board games. You can look through family photo albums together, read together, even do housework together. The more routine family time can be, the better.   In the description of this episode, you’ll find further resources that can help you navigate parenthood with your new diagnosis. These include a list of common questions and answers, activity ideas, and advice for getting through those tough conversations.   In addition to parenthood, you might be struggling with stigma from family and friends. Because early onset is so uncommon, you might find that those around you are getting impatient with you or acting frustrated when you are unable to do things as fast or as easily as you used to. To help with this stigma, make sure to educate your loved ones about your disease. Provide them with resources that will help them to understand what you are going through and what they can expect in the months and years ahead. You can even arrange a meeting with your care team and your loved ones, to answer any of their questions and explain your individual situation on a deeper level.   In the early stages of the disease, it’s essential to plan ahead for the future. This means legal and financial planning, so your family is not left confused and lost when they need this information later on.   You will likely feel daunted and overwhelmed when it comes to legal planning – so don’t be afraid to enlist the help of friends, family, and a lawyer to make sure that everything is taken care of and you are not having to carry this weight on your own.   Begin by organizing all important legal documents to your name, making necessary updates, and putting a plan in place for future finances for your healthcare, long-term care, and will. Give someone you trust power of attorney for when you are no longer to make legal decisions. A person with power of attorney will be able to make decisions for you and sign for you on important documents. Make sure that this person is fully aware of everything you want and need for the future, so they can make sure to make decisions based on your own plans and hopes.   Financial planning will include organizing documents and checking over your assets and debts, so you know exactly what you are responsible for down the road. Choose a family member, or family members, to help you with your financial plans when you are no longer able to. This person should have intimate knowledge about your finances and have your best interests in mind and in heart.   Find out the care options available to you and what they might cost. Whether you choose a family caregiver, hired home care, a nursing home, memory home, or assisted living facility will depend on what you can afford and what you desire. Check your insurance and benefits. Patients with early onset Alzheimer’s disease will be eligible for Medicaid. You might also have long-term care insurance, life insurance, or other health insurance that can help you pay for care costs. If you are still working, see if your employer has any disability or early retirement benefits that might help you.   It is recommended that people with memory issues stay in familiar surroundings, as strange places can quicken the progression of the disease. To learn more about choosing the right care, listen to our episodes on Alzheimer’s, dementia, and long-term care options.   Early onset dementia is an extremely difficult diagnosis for anyone to face. The more you can prepare for the road ahead, though, the more you can focus on spending precious time with your friends and family and doing what you love, instead of worrying about an uncertain future. Start planning today for the road ahead.   We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them. Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. On our next episode we will be welcoming several guests who will be sharing how they have remained engaged, active, and building friendships and socializing while quarantining during covid. This is an interview you won’t want to miss!   Here are the resources used for this episode:   https://www.alz.org/help-support/i-have-alz/younger-onset   https://www.alz.org/alzheimers-dementia/what-is-alzheimers/younger-early-onset   https://www.alz.org/alzheimers-dementia/what-is-alzheimers/causes-and-risk-factors/genetics   https://www.alz.org/help-support/i-have-alz/live-well/taking-care-of-yourself   https://www.alz.org/help-support/resources/kids-teens/for_parents_teachers   https://www.alz.org/help-support/i-have-alz/plan-for-your-future/financial_planning   https://www.alz.org/help-support/i-have-alz/plan-for-your-future/financial_planning   https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048356   https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/earlyonset-alzheimer-disease   https://memory.ucsf.edu/genetics/familial-alzheimer-disease   https://rarediseases.info.nih.gov/diseases/632/familial-alzheimer-disease   https://www.cbsnews.com/news/pat-summitts-death-what-to-know-about-early-onset-alzheimers/          

Memantine is a NMDA antagonist that goes by the brand name Namenda. There are also titration packs available in the name brand. Memantine treats but does not cure confusion and dementia associated to Alzheimer's disease. There are multiple dosage forms being a capsule, solution, and tablet. Special considerations are for patients with renal and hepatic impairment. Memantine does appear to have higher exposure in women than men. Memantine is purposed to work on the glutamate receptor blocking the receptor much like magnesium does under “normal” conditions. This drug has a long elimination half-life between 60-80 hours. The main side effects are weight gain, abdominal pain, constipation, diarrhea and vomiting. A serious side effect is Stevens Johnson Syndrome. Two main types of drugs that interact with Namenda are alkalinizing agents and carbonic anhydrase inhibitors. The drug can be taken with or without food and if a dose is missed it should not be doubled on the next dose. The missed dose should be skipped and resumed regularly. Go to DrugCardsDaily.com for episode show notes which consist of the drug summary, quiz, and link to the drug card for FREE! Please SUBSCRIBE, FOLLOW, and RATE on Spotify, Apple Podcasts, or wherever your favorite place to listen to podcasts are. The main goal is to go over the Top 200 Drugs with the occasional drug of interest. Also, if you'd like to say hello, suggest a drug, or leave some feedback I'd really appreciate hearing from you! Leave a voice message at anchor.fm/drugcardsdaily or find me on twitter @drugcardsdaily --- Send in a voice message: https://anchor.fm/drugcardsdaily/message

Jonathan answers questions about...0:15 Tolerance & cycling strategies3:25 Memantine vs Caffeine8:36 Natural alternatives to the Racetams13:00 Aniracetam & attention17:00 BromantaneFor all resources mentionedhttps://www.limitlessmindset.com/podcast/1416-q-a-2Confused?If you invest at least $100 in your Biohacking via LimitlessMindset.com, I will include a 30-minute free Biohacking consulting call with you. See my recommended Nootropics sources and Biohacking products here:https://www.limitlessmindset.com/membership/secret-societyForward a receipt of at least $100 to Consultations@LimitlessMindset.comJoin the Limitless Mindset email newsletterhttps://www.limitlessmindset.com/membership/community-membershipSupport My WorkMy Bookshttps://www.limitlessmindset.com/jr-booksDonateBitcoin: 36nU1hC5hGUurNY32F3cTWzjj8wbru5nFQConnect with Jonathanon Facebookhttps://www.facebook.com/limitlessmindseton Twitterhttp://twitter.com/jroselandon Instagramhttps://www.instagram.com/roselandjonathan/on Gabhttps://gab.com/jroselandon Mindshttps://www.minds.com/jroselandon LBRYhttps://lbry.tv/@jroseland:fon Telegramhttps://t.me/limitlessjrI'm not a doctor, medical professional, or trained therapist. I'm a researcher and pragmatic biohacking practitioner exercising free speech to share evidence as I find it. I make no claims. Please practice skepticism and rational critical thinking. You should consult a professional about any serious decisions that you might make about your health.

Can you believe this is our 100th episode??? It has been a little over 6 months since our official launch and we are now running full steam, thanks to a hardworking team. Cheers to the members of AMiNDR, and cheers to you for listening to us. This episode is for those of you who are interested in what's already on the marker for treating Alzheimer's diseases. That's right, you have knowingly or by chance stumbled upon our episode on refining or repurposing existing medications, as well as improving methods of drug delivery. You will hear about advances in refining the use of Memantine, Donepezil, and Rivastigmine, and exploring the potential of drugs like Lithium, Escitalopram, or Sildenafil to alleviate the symptoms of AD. We also cover papers that look at refining methods of drug delivery, efficiency, or bioavailability. Sections in this episode:  Section 1: Refining existing drugs 3.53 Memantine (1 paper): 4.26 Donepezil (3 papers): 6.03 Rivastigmine (1 paper): 12.55 Section 2: Refining methods (delivery, efficiency, bioavailability): (5 papers) 15.25 Section 3: Repurposing approved drugs (6 papers): 28.26 Bonus paper: 43.29 ------------------------------------------------------------------ To receive the list of papers covered, please fill this form:  -------->  https://forms.gle/CVVbznAFM8pamdgk6  -------  or by tweeting at us: @AMiNDR_podcast  ------------------------------------------------------------------ We would appreciate your feedback so we can better cater to your needs.  You can fill our feedback form here  ---------->  https://forms.gle/5aq2JyrT6g4P1m8v6  You can also share your thoughts and suggestions by contacting us:  Email: amindrpodcast@gmail.com  Facebook:  AMiNDR  Twitter: @AMiNDR_podcastInstagram: @AMiNDR.podcast------------------------------------------------------------------ Today's episode was scripted by Sarah Louadi and Naila Kuhlmann, reviewed by Joseph Liang, and hosted and edited by Sarah Louadi. All of this was made possible thanks to an entire team of volunteers behind the scenes.  Our music is from "Journey of a Neurotransmitter" by musician and fellow neuroscientist Anusha Kamesh; you can find the original piece and her other music on soundcloud under Anusha Kamesh or on her YouTube channel, AKMusic.  https://www.youtube.com/channel/UCMH7chrAdtCUZuGia16FR4w  ------------------------------------------------------------------ If you are interested in joining the team, send us your CV by email. We are specifically looking for help with abstract summary and podcast editing. However, if you are interested in helping in other ways, don't hesitate to apply anyways.  ------------------------------------------------------------------ *About AMiNDR: *  Learn more about this project and the team behind it by listening to our first episode: "Welcome to AMiNDR!"

Did you know that most people with dementia don’t notice that they’ve had memory loss or personality changes? It tends to be relatives and close friends that notice it and then encourage the individual to seek an evaluation. I learned from the guest on this episode that the “self awareness” part of the brain is likely to be one of the areas harmed by dementia! In this episode, also learn: How do Dementia symptoms differ from normal aging? How can one tell the difference between Dementia and depression? What does research recommend on how to prevent dementia?What steps should you or family take once a Dementia diagnosis has been made?What is the latest technology on identifying Alzheimer’s Disease?What is it like for those caring for the Dementia patient? The guest on today’s episode is Dr. Michelle Papka (www.thecrcnj.com, 973-850-4622), who has nearly 25 years' combined experience as a researcher and clinician specializing in the field of aging, Alzheimer’s disease, and dementia. She practices as a neuropsychologist, psychotherapist, and researcher, and has served as the Principal Investigator on over 20 recent clinical trials for Alzheimer’s disease, memory impairment, or mild cognitive impairment.She’s had numerous publications of her work and is an active public speaker, invited editor, grant reviewer, consultant, and committee member of multiple specialized organizations and publications in the field of aging and Alzheimer’s Disease.

Dr. Don Marion and Dr. Anne Bunner discuss whether a drug known for treating Alzheimer’s, which may have some neuroprotective effects, could improve short-term neurological function in patients with moderate TBI. Publication: Mokhtari, M., Nayeb-Aghaei, H., Kouchek, M., Miri, M.M., Goharani, R., Amoozandeh, A., Akhavan Salamat, S., Sistanizad, M. (2017). Effect of Memantine on Serum Levels of Neuron-Specific Enolase and on the Glasgow Coma Scale in Patients With Moderate Traumatic Brain Injury. Journal of Clinical Pharmacology. Epub ahead of print. doi: 10.1002/jcph.980 PubMed link: www.ncbi.nlm.nih.gov/pubmed/28724200 CUBIST is a podcast for health care providers produced by the Defense and Veterans Brain Injury Center. We discuss the latest research on traumatic brain injury (TBI) most relevant to patient care. For more about TBI, including clinical tools, go to dvbic.dcoe.mil or email us at dha.DVBICinfo@mail.mil The views, opinions and/or findings contained in this podcast are those of the host and subject matter experts. They should not be construed as an official Department of Defense position, policy or decision unless so designated by other official documentation. All music in this podcast was used according to Creative Commons licensing. Our theme song is "Dog Wind" by Skill_Borrower, and our credit music is "Esaelp Em Xim" by Pitx, both from CCmixter.org. All music in this podcast was used according to Creative Commons licensing.

Caregivers can spot dementia in numerous ways, ranging from a loved one forgetting about their favorite television program to suddenly not remembering to pay their bills on time. Learn who Dr. Cesar Torres says is most at risk of dementia and how to manage it.   TRANSCRIPT Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine. Host: We’re speaking with Dr. Cesar Torres, a geriatric and house-call doctor at MedStar Washington Hospital Center. Thank you for joining us, Dr. Torres. Dr. Torres: Good afternoon. Host: Today we’re discussing dementia, a neurological condition that tends to develop in older adults and is characterized by memory loss and confusion. Dr. Torres, could you start by discussing how dementia develops in the brain? Dr. Torres: Certainly. Dementia develops as a result of the production of a neurotoxic protein called beta amyloid and, as a result of accumulation of this protein, nerve cells in certain areas start to die, specifically the memory centers of the brain - the hippocampus, the parietal lobe - and, as a result, people start to experience neurocognitive deficits. The most dramatic ones tend to be in the memory realm, but there are other cognitive deficits that also develop. And these eventually lead to significant social dysfunction and impairment, and it’s, unfortunately, very progressive. Host: Are there any populations of people who are at increased risk for dementia? Dr. Torres: Well, the number one risk factor for dementia is age. The older you are, the higher the prevalence. Recent estimates - generally, by the time you’re 70-75, there’s upwards of a 20 percent prevalence rate. Dementia encompasses a few different pathologies. There’s Alzheimer’s dementia, there’s Vascular dementia, there is a dementia associated with Parkinson’s, there’s a Lewy body dementia and there are some other much more esoteric subtypes. The vast majority are Alzheimer’s-type dementia, generally in the range of 60, 70 percent. After that, Vascular dementia rounds off the list, mostly around 15 to nearly 20 percent. And then, all the others. So, each one tends to have certain predispositions. For Alzheimer’s, there’s a genetic predisposition. It’s not 100 percent correlative, but there is a genetic predisposition and it can run in families. Vascular dementia tends to affect folks who have vascular disease - hypertension, coronary artery disease, people who are more prone to strokes. Brain trauma can predispose people to another subtype of dementia, and there’s a lot of focus now on this Traumatic encephalopathy that we see in a lot of professional, high-contact sports. Some of the other more esoteric subtypes - probably more of a genetic predisposition. So, as far as high-risk groups are concerned, that’s not an all inclusive list but there are certain groups that are at greater risk. But like I said, age is the number one risk factor. So, if people could stop growing old, we wouldn’t have a problem. Host: In these high-risk individuals and these aging individuals, what are some of the warning signs of dementia that families should start watching for? Dr. Torres: That’s a very good question and unfortunately, it’s also a very broad question. Generally, the onset of Alzheimer’s tends to be extremely subtle. You’ll tend to see problems with the acquisition of new knowledge or new information, the retention of new knowledge and new information. A family member asks how to get to a grocery store over and over again, in spite of having been there not too recently. You can see difficulty with social functioning as well, as the disease progresses. An individual who was extremely capable of managing their finances suddenly forgets to pay their bills and the electricity gets turned off. As things progress, now you can see personality changes. Sometimes the person starts to retreat into themselves - more withdrawn as some awareness of the social dysfunction starts to creep into their consciousness. Generally, the family will feel something isn’t quite right with their loved one and that’s when they actually probably bring it to the attention of their primary care physician or caregiver. The social functioning piece becomes more dramatic and is more distressing for folks, and they tend to pick up on that fairly quickly because it’s a dramatic departure from previous level of functioning. Host: If someone notices that a loved one is showing signs of dementia, where should they turn for help? Dr. Torres: Generally, most primary care physicians can do at least the initial screening. This generally can include blood tests, neuro imaging - in the form of a CT scan or an MRI. There are some blood tests that can also help rule out reversible causes of memory loss. But generally, the primary care physician should be the first point of contact. Host: Are there any treatment options available to help patients with dementia manage their symptoms or reverse the condition? Dr. Torres: Well, unfortunately, we have no way to reverse it at the current time. And that’s the Holy Grail. There have been many, many, many attempts to find drugs and various treatments but none have really been successful up to this point. As far as medications to modify the progression of the disease, there are a few, the most famous one being Donepezil, trade name Aricept and Namenda, generic Memantine. If  you make a diagnosis of dementia, you don’t automatically use the medication. It’s best to have a conversation with the patient and the family and to decide whether or not the patient has reached the stage where they would benefit from this medication because all of these medicines has toxicity. What the medicines offer, really, are slowing the progression. And, you may see unfortunately temporary improvements in certain memory functions. But, unfortunately, over time, the effect diminishes and the disease starts to progress again. If you look at it on a bell curve, most folks will fall in the middle. They will get some, but there are those who can get a lot and there are some who, unfortunately, don’t get anything. The middle is where the bulk of the patients will fall. But on an individual, case by case basis, you can get a substantial amount of improvement. The biggest benefit, I feel, from starting treatment with these medications is time. You buy time. And time is very precious for people. So, on the basis of that, if we’re at a relatively early enough stage, I think it’s a worthwhile choice. Host: You mentioned a couple of different potential causes for dementia. What can patients do to reduce their risk of developing it? Dr. Torres: We have looked at lots and lots of different options - herbal medications, anti-inflammatories, Vitamin E - and the list goes on. But, to date, the only two things that I can recommend honestly? A healthy lifestyle and daily exercise. Daily exercise actually has evidence behind it. So, among all the other benefits that a person can obtain from daily exercise, prevention of dementia is another one. There was a sub-analysis of the Women’s Health Initiative Study that was done a few years ago that looked at the impact of exercise and noted that it reduced their relative risk by about 40 percent, as a result of daily cardiovascular exercise. The reasons for that, the mechanism behind it - still remains a bit unclear but I suspect it has to do with just overall benefits of exercise and physical activity. And it doesn’t need strenuous exercise also, but some form of daily cardiovascular exercise would be a great benefit. Well, I would recommend being very judicious with alcohol intake. There is an Alcoholic dementia that exists. Otherwise, avoiding smoking. Smoking can lead to vascular problems that can lead to Vascular dementia. Good sleep, weight control - things like that. Host: How do the dementia experts in the geriatrics program and the house-call program at MedStar Washington Hospital Center help patients and families achieve optimal outcomes? Dr. Torres: The number one way is in the diagnosis of the condition because sometimes it can present atypically. Sometimes it can present, as I said, very subtly. So, sometimes it has to be teased out. And again, it’s time. We can gain time for better interactions, more complete interactions with the patient and the family member. And there are a few conditions that can masquerade like dementia that we can treat and reverse the symptoms that we associate with dementia - the memory loss. The one that is most well known is depression. Depression can manifest itself as a type of dementia with memory loss, with loss of concentration, with apathy, as well. And so by treating that, the patient -- effectively treating that -- the patient can regain their function and their memory. Host: Could you give us an example of how you care for a dementia patient through the house-call program? Dr. Torres: Well, we have a very focussed approach with really educating and helping the caregiver meet the needs and ease the process for the patient. There’s usually a lot of frustration that the caregiver feels with their loved one as the disease progresses. And the deficits become more and more overwhelming. So, we tend to review behavioral techniques that can ease the tension in the household. We can help them with treating comorbidities to maximize their time at home. And we do everything we can to help the patient age in place, which is often a great benefit for everyone - avoids unnecessary trips to the emergency department, unnecessary hospitalizations. Host: Thanks for joining us today, Dr. Torres. Dr. Torres: It was my pleasure. Conclusion: Thanks for listening to Medical Intel with MedStar Washington Hospital Center. Find more podcasts from our healthcare team by visiting medstarwashington.org/podcast or subscribing in iTunes or iHeartRadio.

Memantine is classified as an NMDA receptor antagonist. Memantine pharmacology is complex as is the pharmacology of any medication working in the brain. This drug can help reduce the activity of glutamate, an excitatory neurotransmitter which can play a role in Alzheimer's dementia. Memantine has an extended release dosage form that is dosed once per day compared to twice per day for the immediate release. However, the cost of the extended release is much more expensive, so it is recommended to begin with the immediate release. Memantine is cleared by the kidney. In patients with reduced kidney function, you must review to assess if the memantine dose needs to be adjusted. When using memantine or other dementia medications, be sure to look out for medications that can cause dementia type symptoms. CNS depressants like benzodiazepines, sleep medicines, and anticholinergics are all examples of meds that could exacerbate dementia.

All Science References & Sourceshttp://www.limitlessmindset.com/nootropic-ingredients/324-memantine Connect with Jonathanon Facebookhttps://www.facebook.com/limitlessmindseton Twitterhttp://twitter.com/#!/jroselandon Google+https://plus.google.com/+JonathanRoselandOn Coach.mehttps://www.coach.me/users/18dbe22f0cb6519b290d

Dr. Don Marion and Dr. Anne Bunner discuss whether a drug known for treating Alzheimer’s, which may have some neuroprotective effects, could improve short-term neurological function in patients with moderate TBI. Publication: Mokhtari, M., Nayeb-Aghaei, H., Kouchek, M., Miri, M.M., Goharani, R., Amoozandeh, A., Akhavan Salamat, S., Sistanizad, M. (2017). Effect of Memantine on Serum Levels of Neuron-Specific Enolase and on the Glasgow Coma Scale in Patients With Moderate Traumatic Brain Injury. Journal of Clinical Pharmacology. Epub ahead of print. doi: 10.1002/jcph.980 PubMed link: https://www.ncbi.nlm.nih.gov/pubmed/28724200 CUBIST is a podcast for health care providers produced by the Defense and Veterans Brain Injury Center. We discuss the latest research on traumatic brain injury (TBI) most relevant to patient care. For more about TBI, including clinical tools, go to dvbic.dcoe.mil or email us at info@dvbic.org. The views, opinions and/or findings contained in this podcast are those of the host and subject matter experts. They should not be construed as an official Department of Defense position, policy or decision unless so designated by other official documentation. All music in this podcast was used according to Creative Commons licensing. Our theme song is "Dog Wind" by Skill_Borrower, and our credit music is "Esaelp Em Xim" by Pitx, both from CCmixter.org.

What is the role for the neuroprotective agent memantine in patients receiving whole brain radiation therapy for brain metastases? Dr. Vivek Mehta reviews current practices to minimize risk of cognitive problems.

What is the role for the neuroprotective agent memantine in patients receiving whole brain radiation therapy for brain metastases? Dr. Vivek Mehta reviews current practices to minimize risk of cognitive problems.

What is the role for the neuroprotective agent memantine in patients receiving whole brain radiation therapy for brain metastases? Dr. Vivek Mehta reviews current practices to minimize risk of cognitive problems.

Interview with Maurice W. Dysken, MD, author of Effect of Vitamin E and Memantine on Functional Decline in Alzheimer Disease: The TEAM-AD VA Cooperative Randomized Trial

Anthony Zietman talks with author Nadia Laack about this game-changing research

Mon, 1 Jan 2001 12:00:00 +0100 https://epub.ub.uni-muenchen.de/16810/1/10_1159_000052094.pdf Soyka, Michael; Schütz, Christian G.; Bartenstein, P.; Bahlmann, Miriam; Preuss, Ulrich W. ddc:61