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The beneficial effect on behavior of cholinesterase inhibitors (galantamine, metrifonate) and a muscarinic cholinergic agonist (xanomeline) includes a delay or decrease in the emergence of behavioral disturbances, as well as a reduction in existing problem behaviors.

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Cholinesterase inhibitors remain the most common form of drug therapy prescribed for symptomatic relief of cognitive dysfunction in AD, and this concept is being challenged as the most effective treatment modality for AD based upon basic science, translational and clinical studies during the progression of AD.

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December 2001 Outpatient trial of sertraline in children and adolescents with major depressive disorder.

Currently, naturalistic patients with AD are treated with ChEIs without actual knowledge of their plasma or CSF concentration.

December 2007 A Multicenter, Double-Blind, Flexible-Dose, 6-Month Trial Comparing the Efficacy and Safety of Asenapine with Olanzapine in Stable Subjects with Predominant, Persistent Negative Symptoms of Schizophrenia.

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Eighty-four patients with AD recruited from the Memory Clinic, Malmö, Sweden, and treated with galantamine were included in the study.

While the general assumption has been that cognitive deficits are a feature of late-stage PD, clinically inapparent cognitive changes on neuropsychiatric testing may be found ().

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Nor do we know if a person with multiple dementias can benefit from treating one type, for example, when a person with AD controls high blood pressure and other vascular disease risk factors.

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Further studies of SSRIs, especially sertraline (Zoloft), have found no significant effects on neuropsychiatric symptoms but have found these agents efficacious in treating concomitant depression and anxiety in patients with dementia (Finkel et al.

They are chemically the same and since the active ingredient is identical they have the same medical effect as brand drugs.

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This results in a 15% chance of having a child with Down syndrome when the mother is affected and a less than 5% probability if the father is affected.

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Selective serotonin reuptake inhibitors (SSRIs) have been recommended as first-choice antidepressants in PD considering their tolerability, and acceptable side effect profile and drug-drug interactions ().

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Discovered in the 1950s, galantamine is an alkaloid isolated from Galanthus nivalis, the common snowdrop.

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For treating acute behavioral disturbances that pose a risk to patient and staff, it is evident that rapid-acting psychotropics are superior to placebo.

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Ketoconazole: Ketoconazole, a strong inhibitor of CYP3A4 and an inhibitor of CYP2D6, at a dose of 200 mg BID for 4 days, increased the AUC of galantamine by 30%.

Therefore patients with very mild AD can obtain significant benefits from galantamine treatment despite the lack of sensitivity of the rating instruments in that severity range.

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The vagus nerve regulates metabolic homeostasis by controlling heart rate, gastrointestinal motility and secretion, pancreatic endocrine and exocrine secretion, hepatic glucose production, and other visceral functions.

It is reasonable to suppose that the control group's decline would have been greater still, had they not been taking galantamine for the last six months of the study.

Smoking history (for example, cigarettes per day, age smoking initiation) and the Fagerström Test for Nicotine Dependence; were assessed at the eligibility screen.

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Improved” or “stable” galantamine-treated patients displayed mean improvement in ADAS-Cog 11 scores over baseline until 18 months after starting treatment, with lessened deterioration thereafter.

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University of Pittsburgh, now Vice President and Dean of the School of Medicine at the University of Virginia in Charlottesville, conducted the 8-year study at four clinical sites.

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