J Korean Geriatr Psychiatry.
1999 Dec;3(2):119-128.
Pharmacotherapy of Vascular Dementia
- Affiliations
-
- 1Department of Neuropsychiatry, School of Medicine, and Institute of Neuroscience, Inje University, Pusan, Korea.
Abstract
- Although many drugs are currently available in the treatment of vascular dementia, there are no licensed drugs for it with proven efficacy. The major treatment efforts are therefore focused on the management of the underlying causes and control of risk factors. Antiplatelet agents or anticoagulants such as a low dose of aspirin or warfarin should be used in all patients where there is no contraindication. Hypertension should be properly controlled not to make the patient hypotensive. Blood cholesterol and triglyceride, especially LDL cholesterol, should be assessed and, if raised, treated using diet or drugs. And if the patient is diabetic, it should be controlled also. If the patient is a smoker, they should be encouraged to stop smoking. Supportive measures such as gait retraining, prophylaxis against limb contractures, and speech therapy are indicated in selected patients. Pathophysiological processes common to both vascular dementia and dementia of Alzheimer's type may include microglial activation, increased production of cytokines, free radicals and glutamate. Propentofylline, a neuroprotective glial cell modulator, has been shown to be effective in the management of the patients with Alzheimer's disease or vascular dementia. Other therapies such as estrogen, non-steroid anti-inflammatory drugs and anti-oxidants such as vitamin E/selegiline (MAO-B inhibitor), Gingko biloba are sometimes used and show promise in delaying the progression of dementia. But several further clinical trials are needed to determine whether these new therapies can be successfully used in patients with vascular dementia or dementia of Alzheimer's type.
Keyword
MeSH Terms
-
Alzheimer Disease
Anticoagulants
Aspirin
Cholesterol
Cholesterol, LDL
Contracture
Cytokines
Dementia
Dementia, Vascular*
Diet
Drug Therapy*
Estrogens
Extremities
Free Radicals
Gait
Ginkgo biloba
Glutamic Acid
Humans
Hypertension
Neuroglia
Platelet Aggregation Inhibitors
Risk Factors
Smoke
Smoking
Speech Therapy
Triglycerides
Vitamins
Warfarin
Anticoagulants
Aspirin
Cholesterol
Cholesterol, LDL
Cytokines
Estrogens
Free Radicals
Glutamic Acid
Platelet Aggregation Inhibitors
Smoke
Vitamins
Warfarin
