drug treatments and dementia. edited by stephen hopker. jessica kingsley publishers. pages: 128....

2
a bad experience, like I was surrounded by water and drowning, it must have been panic'. Chapter 6 focuses upon MDMA's adverse effects, although a degree of medical expertise is often needed by the reader: laboratory evidence suggested rhabdomyolysis, co- agulopathy, thrombocytopenia, delayed leukocytosis, and toxic hepatitis. The patient made a full recovery. Others with similar complications do not survive' page 75). Although there is a medical glossary, many de®nitions fail to illuminate, or appear incorrect. Hyponatremia is de®ned as: abnormally low levels of sodium in the blood, typically occurring during dehydration' page 122). But the hyponatraemic pro- blems of ecstasy casualties generally follow from excess rehydration: drinking too much water follow- ing the drug/dance induced hyperthermia. Most of the non-medical passages are written in a user-friendly style, but this book does suffer from two serious weaknesses. It is o¯en super®cial and descriptive with little attempt at theoretical integration or understanding. The ®nal overview chapter is parti- cularly disappointing for a highly topical drug with such an intriguing neuroscienti®c pro®le. It is also trite to state: the entire notion of extrapolating animal research ®ndings to humans continues to remain con- troversial' page 27), particularly since this ®eld is an excellent example of how animal and human research complement each other Ricaurte et al., 2000). Controlled animal research demonstrates serotonergic neural damage exacerbated by heat), while human research is uncovering an increasing array of psycho- biological problems in young recreational users. This raises the second main weakness of the text, namely the paucity of information on the neuro-cognitive effects of MDMA. Clinical reports of memory pro- blems in heavy ecstasy users were ®rst reported by Ricaurte in 1993. We found signi®cant memory de®- cits in young novice ecstasy users in 1996, and cogni- tive/memory problems, together with psychiatric and psychobiological problems Parrott et al., 2000), have now been repeatedly con®rmed Parrott, 2000). These de®cits are related to the amount of drug which has been taken, are evident in regular users who state that they have no problems, and remain in former users who have stopped using MDMA. Cohen's Love Drug gives the impression that many ecstasy users will have a good time on drug, although a few unlucky ones may develop severe medical complications. Our ®ndings present a far more worrying scenario: enduring sero- tonergic damage in regular users of MDMA. REFERENCES Ricaurte GA, Yuan J, McCann UD. 2000. Neuropsychobiology 42: 5±10. Parrott AC. 2000. Neuropsychobiology 42: 17±24. Parrott AC, Sisk E, Turner JJD. 2000. Drug and Alcohol Depen- dence 60: 105±110. ANDY P ARROTT Department of Psychology University of East London Ramford Road, London E1S 4LZ, UK DOI: 10.1002/hup.261 Drug Treatments and Dementia. Edited by Stephen Hopker. Jessica Kingsley Publishers. Pages: 128. ISBN: 1-85302-760X. This is an important topic and one that has become increasingly relevant over the past few years with the availability of anti-dementia drugs and a greater willingness of health authorities to approve funding. These are not miracle' cures but can signi®cantly improve symptoms and quality of life for patients with these distressing disorders and this book provides an up-to-date and comprehensive account of these treat- ments. This book covers a range of areas including a very helpful introduction followed by a review of the beha- vioural and other psychiatric problems encountered in patients with dementia. This is followed by a review of the principles of drug treatment in dementia. There is also a good chapter evaluating the new antidementia drugs, including donepezil and rivastigmine, but a number of other drugs are also mentioned. The section on antipsychotics and dementia, though very readable and informative, could have been a little bit more detailed. The book is very easy to read and it is well pre- sented in a logical order, with clear headings, use of bullet points and some excellent case studies. The book is well referenced and it also contains some very useful appendices on antipsychotic side effects, and side effects and dosages of antidepressants. Overall, this is a very readable and compact intro- duction to drug treatments for dementia, that would be suitable for a wide range of healthcare professionals, including those working in primary care. It would also be very useful to geriatricians and psychiatrists in var- ious stages of training. It is likely to be of interest also book reviews 285 Copyright # 2001 John Wiley & Sons, Ltd. Hum Psychopharmacol Clin Exp 2001; 16: 282±286.

Upload: stephen-curran

Post on 11-Jun-2016

212 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Drug treatments and dementia. Edited by Stephen Hopker. Jessica Kingsley Publishers. Pages: 128. ISBN: 1-85302-760X

) #)! �97����*&�' %��� 1 �)� �,���,*!�! #$ �)"�� )*!!���*�*5' �" 4,�" .)�� #��* 7)*�&A� .)7"�� � 8�&,���,7�* �>��A� )!����� �88�&"�' )%".�,5. ) !�5��� �84�!�&)% �97��"��� �� �8"�* *��!�! #$ ".� ��)!���%)#��)"��$ ���!�*&� �,55��"�! �.)#!�4$�%$���' &�+)5,%�7)".$' ".��4#�&$"�7�*�)' !�%)$�! %�,��&$"����')*! "�9�& .�7)"�"��� -.� 7)"��*" 4)!� ) 8,%% ��&����$�".��� ��". ��4�%)� &�47%�&)"��*� !� *�" �,�����A:7)5� 3E;� �%".�,5. ".��� �� ) 4�!�&)% 5%���)�$' 4)*$!�=*�"��*� 8)�% "� �%%,4�*)"�' �� )77�)� �*&����&"��$7�*)"��4�) �� !�=*�! )�� )#*��4)%%$ %�� %���%��8 ��!�,4 �* ".� #%��!' "$7�&)%%$ �&&,���*5 !,��*5 ��� ��"��A :7)5� ���;� �," ".� .$7�*)"�)�4�& 7��+#%�4� �8 �&�")�$ &)�,)%"��� 5�*��)%%$ 8�%%�� 8��4�9&��� ���� ��"��� !��*��*5 "�� 4,&. �)"�� 8�%%��+�*5 ".� !�,5?!)*&� �*!,&�! .$7��".��4�)����" �8 ".� *�*+4�!�&)% 7)��)5�� )�� ���""�* �* )

,���+8���*!%$ �"$%�' #," ".�� #��� !��� �,88�� 8��4"�� �����,� ��)�*������ 1" �� �H�* �,7��=&�)% )*!!��&��7"��� ��". %�""%� )""�47" )" ".����"�&)% �*"�5�)"��*�� ,*!���")*!�*5� -.� =*)% �������� &.)7"�� �� 7)�"�+&,%)�%$ !��)77��*"�*5 8�� ) .�5.%$ "�7�&)% !�,5 ��".�,&. )* �*"��5,�*5 *�,���&��*"�=& 7��=%�� 1" �� )%��"��"� "� �")"�� ".� �*"��� *�"��* �8 �9"�)7�%)"�*5 )*�4)%����)�&. =*!�*5� "� .,4)*� &�*"�*,�� "� ��4)�* &�*+"�������)%A :7)5� �3;' 7)�"�&,%)�%$ ��*&� ".�� =�%! �� )*�9&�%%�*" �9)47%� �8 .�� )*�4)% )*! .,4)* ����)�&.&�47%�4�*" �)&. �".�� :��&),�"� �" � -' ����;��*"��%%�! )*�4)% ����)�&. !�4�*�"�)"�� ����"�*��5�&*�,�)% !)4)5� :�9)&��#)"�! #$ .�)";' �.�%� .,4)*����)�&. �� ,*&�����*5 )* �*&��)��*5 )��)$ �8 7�$&.�+#��%�5�&)% 7��#%�4� �* $�,*5 ��&��)"��*)% ,����� -.��

�)���� ".� ��&�*! 4)�* ��)�*��� �8 ".� "�9"' *)4�%$".� 7),&�"$ �8 �*8��4)"��* �* ".� *�,��+&�5*�"����88�&"� �8 �>��� %�*�&)% ��7��"� �8 4�4��$ 7��+#%�4� �* .�)�$ �&�")�$ ,���� ���� =��" ��7��"�! #$��&),�"� �* �00<� /� 8�,*! ��5*�=&)*" 4�4��$ !�=+&�"� �* $�,*5 *���&� �&�")�$ ,���� �* �00�' )*! &�5*�+"���?4�4��$ 7��#%�4�' "�5�".�� ��". 7�$&.�)"��& )*!7�$&.�#��%�5�&)% 7��#%�4� :�)���"" �" � -' ����;' .)��*�� #��* ��7�)"�!%$ &�*=�4�! :�)���""' ����;� -.���!�=&�"� )�� ��%)"�! "� ".� )4�,*" �8 !�,5 �.�&. .)�#��* ")��*' )�� ���!�*" �* ��5,%)� ,���� �.� �")"� ".)"".�$ .)�� *� 7��#%�4�' )*! ��4)�* �* 8��4�� ,�����.� .)�� �"�77�! ,��*5 �>��� �.�*A� 1%� !���5���� ".� �47������* ".)" 4)*$ �&�")�$ ,���� ��%% .)��) 5��! "�4� �* !�,5' )%".�,5. ) 8�� ,*%,&�$ �*�� 4)$!���%�7 ������ 4�!�&)% &�47%�&)"��*�� ,� =*!�*5�7����*" ) 8)� 4��� ����$�*5 �&�*)���� �*!,��*5 ����+"�*��5�& !)4)5� �* ��5,%)� ,���� �8 �>���

� @ � � �

��&),�"� �' �,)* (' �&)** �>� ����� #�������.� �� ���E����

�)���"" �� ����� #�������.� �� ��� �3��2��)���"" �' ���� ' -,�*�� ((>� ����� !��� �� , �� !���/

���� ��� ��E�����

��>� ����--!���"���" & ����� ��$��%����"� & ���" 1� �

���&� �� ) 1� � �3� 415) $����� �������?.,7����

!��� ����"���"� �� !����"��� !�"�! #$ �"�7.�*��7���� (����&) D�*5�%�$ �,#%��.���� �)5��� ����1���� �+�E<��+3��J�

-.�� �� )* �47��")*" "�7�& )*! �*� ".)" .)� #�&�4��*&��)��*5%$ ��%��)*" ���� ".� 7)�" 8�� $�)�� ��".".� )�)�%)#�%�"$ �8 )*"�+!�4�*"�) !�,5� )*! ) 5��)"����%%�*5*��� �8 .�)%". ),".���"��� "� )77���� 8,*!�*5�-.��� )�� *�" 4��)&%�A &,��� #," &)* ��5*�=&)*"%$�47���� �$47"�4� )*! 6,)%�"$ �8 %�8� 8�� 7)"��*"� ��".".��� !��"�����*5 !����!��� )*! ".�� #��� 7����!�� )*,7+"�+!)"� )*! &�47��.�*���� )&&�,*" �8 ".��� "��)"+4�*"��-.�� #��� &����� ) �)*5� �8 )��)� �*&%,!�*5 ) ���$

.�%78,% �*"��!,&"��* 8�%%���! #$ ) ������ �8 ".� #�.)+���,�)% )*! �".�� 7�$&.�)"��& 7��#%�4� �*&�,*"���! �*7)"��*"� ��". !�4�*"�)� -.�� �� 8�%%���! #$ ) �������8 ".� 7��*&�7%�� �8 !�,5 "��)"4�*" �* !�4�*"�)� -.���

�� )%�� ) 5��! &.)7"�� ��)%,)"�*5 ".� *�� )*"�!�4�*"�)!�,5�' �*&%,!�*5 !�*�7�F�% )*! ���)�"�54�*�' #," )*,4#�� �8 �".�� !�,5� )�� )%�� 4�*"��*�!� -.� ��&"��*�* )*"�7�$&.�"�&� )*! !�4�*"�)' ".�,5. ���$ ��)!)#%�)*! �*8��4)"���' &�,%! .)�� #��* ) %�""%� #�" 4���!�")�%�!�-.� #��� �� ���$ �)�$ "� ��)! )*! �" �� ��%% 7��+

��*"�! �* ) %�5�&)% ��!��' ��". &%�)� .�)!�*5�' ,�� �8#,%%�" 7��*"� )*! ��4� �9&�%%�*" &)�� �",!���� -.�#��� �� ��%% ��8���*&�! )*! �" )%�� &�*")�*� ��4� ���$,��8,% )77�*!�&�� �* )*"�7�$&.�"�& ��!� �88�&"�' )*!��!� �88�&"� )*! !��)5�� �8 )*"�!�7����)*"�����)%%' ".�� �� ) ���$ ��)!)#%� )*! &�47)&" �*"��+

!,&"��* "� !�,5 "��)"4�*"� 8�� !�4�*"�)' ".)" ��,%! #��,�")#%� 8�� ) ��!� �)*5� �8 .�)%".&)�� 7��8�����*)%�'�*&%,!�*5 ".��� �����*5 �* 7��4)�$ &)��� 1" ��,%! )%��#� ���$ ,��8,% "� 5���)"��&�)*� )*! 7�$&.�)"���"� �* �)�+��,� �")5�� �8 "�)�*�*5� 1" �� %���%$ "� #� �8 �*"����" )%��

���� � ���� ��E

�7$��5." � ���� (�.* /�%�$ C ��*�' �"!� ��� ����������� � �� �� ����� ��� ��������

Page 2: Drug treatments and dementia. Edited by Stephen Hopker. Jessica Kingsley Publishers. Pages: 128. ISBN: 1-85302-760X

"� ) �)*5� �8 �".�� .�)%".&)�� 7��8�����*)%� �*&%,!�*5*,���*5 �")88 )*! &%�*�&)% 7�$&.�%�5��"���" "�4��' �*� .)� ".� �47������* ".)" *�" �*�,5.

�*8��4)"��* .)� #��* 5���*' #," ".��� )�� �,8=&��*"��8���*&�� 8�� ".��� �.� ��,%! %��� "� �",!$ ".�� �,#+

B�&" 8,�".��� 1 ".�*� ) #���8 �,44)�$ )" ".� �*! �8 �)&.&.)7"�� ��,%! .)�� .�%7�! "� &�*��%�!)"� ".� �*8��4)+"��* 7����!�!� -.�� #��� ��%% &��")�*%$ .)�� ) 7%)&� �*�,� 4�!�&)% %�#�)�$ )*! 1 )4 �,�� �" ��%% #� 8��6,�*"%$,��!�

���� �� �� � ����� ������� �� & ���.� �� ��"�� !�"�! #$ �� (� ,77' �,4)*) �����'1*&�' ����� 1���� �+�0��<+30�+�� ���&�� �0�E��

-.��� .)� #��* �*&��)��! �*"����" �* .��#)% 7��!,&"����� ".� %)�" E $�)��' )� ���!�*&�! #$ #�". ".� �)7�!5���". �8 ".� .��#)% 4�!�&�*� �*!,�"�$ ���%! ��!�)*! �*&��)��! �)%�� �8 .��#)% 7��!,&"�� ���#)%7��!,&"� .)�� ) �)���"$ �8 7,")"��� ".��)7�,"�&�*!�&)"��*� �*&%,!�*5 4)*$ 7�$&.�)"��& !����!����/�!��7��)! ,�� �8 .��#)% 7��!,&"� .)� &��)"�! ) *��!8�� 7.$��&�)*� "� #�&�4� 4��� �*8��4�! )#�," ".�&,���*" %�"��)",�� ��5)�!�*5 ".��� "��)"4�*"�� �*8��",+*)"�%$ ".��� �� %�4�"�! �&��*"�=& �*8��4)"��* �* 4)*$&�44�*%$ ,��! .��#)% 7��!,&"� �* ��%)"��* "�4�&.)*��4 �8 )&"��*' )&"��� &�*�"�",�*"�' !�,5 �*"��+)&"��*�' )!����� �88�&"� )*! &%�*�&)% �8=&)&$�

���� �� �� � ����� ������� �� & ���.� ��6��"� �� ) &�47%�"� ������ �8 )�)�%)#%� �*8��4)"��*�* ".� 7.)�4)&�%�5$ )*! "�9�&�%�5$ �8 &�44�* .��+#)% 7��!,&"�� -.� ��%,4� �� &�47����! �8 ".��� 7)�"��:�; %�5)%?��5,%)"��$ )�7�&"� �8 .��#)% 7��!,&"�' :�;4�*�5�)7.� �8 �� ��!�%$ ,��! .��#)% 7��!,&"� )*!:<; �,44)�$ �8 "�9�&�"��� )*! !�,5 �*"��)&"��*�� -.�=��" &.)7"�� �* ".� %�5)% )�7�&"� �8 .��#)% 7��!,&"�7����!�� )* �������� �8 ".� ��5,%)"��$ �")",� �8 .��#)%7��!,&"� �* !�88���*" &�,*"����� �,#��6,�*" &.)7"���!��&��#� 4�*�5�)7.� �8 ".� !�88���*" .��#�� ���*5��%�)#%� 7���+�������! !)")' ".� 7.)�4)&�%�5$ )*!"�9�&�%�5$ �8 �)&. .��# �� !��&��#�! ,*!�� ��7)�)"���&"��*� �*&%,!�*5� ��,�&��' .��"��$ )*! "�)!�"��*)%,���' )�)�%)#%� 7��!,&"�' )&"��� &�*�"�",�*"�' �� %�%)*! �� %�"� )*�4)% )*! .,4)* !)") �* �*��* 7.)�4)+&�%�5�&)% )*! "�9�&�%�5�&)% �88�&"�' =*!�*5� 8��4 &)����7��"� )*! &%�*�&)% "��)%� �* �8=&)&$ )*! )!������88�&"�' 7.)�4)&���*�"�&�' !�,5 �*"��)&"��*�' 4�".�!�

�8 &.�4�&)% )*! #��H,�!� )*)%$��� )*! ��5,%)"��$ �")+",�� -.� .��#� ".)" )�� �������! �* ".�� ��%,4��*&%,!�� �) �,)*5 )*! ".� ��� �� �%�)%��!�' D)�)''��*� .� .�' K)%���)*' �"� (�.*A� /��"' .)44�+4�%�' ���������' @����8��' )�%�&' �*5��' �)� �)%+4�""�' ����� �*��*5' �)*#���$' ���)5�' )%)4,�'.)7)��)%' �%"�8��"' �48��$' �&,%%&)7' ��&���&�'�������!' �)��)8�)�' �)�".��*' �%��' ��**)')�&)�) �)5�)!)' >�*5 I,)� )*! )"A� %)��1* 5�*��)% ".� ��%,4� �� ��%% ���""�*' �������*5

�47��")*" �&��*"�=& �*8��4)"��* )*! 7����!�*5 )8,*!)4�*")% �*��%�!5� �8 &�44�*%$ ,��! .��#)%7��!,&"�� -.� �*8��4)"��* �� 7����*"�! �* �,&. )�)$ ".)" �" �� �)��%$ )&&����#%� "� 7.)�4)&�%�5��"�'"�9�&�%�5��"�' 7)".�%�5��"�' 4�!�&)% 7.$��&�)*�' 5�)!,+)"� )*! 7��"+5�)!,)"� �",!�*"�' )*! .�)%". &)�� 7����+!���� �%".�,5. ".� ��%,4� &�47��.�*����%$ �������4��" �8 ".� &�44�* .��#�' �" �� ��4��.)" !��)77��*"+�*5 �* �"� ������ �8 ".� %�"��)",�� �8 ��4� �8 ".� 4�������)�&.�! .��#� �,&. )� �"� (�.*A� /��" )*! '��*�.� .� �* )��)� �,&. )� �8=&)&$ )*! 4�&.)*��4 �8)&"��*� �)��*5 �)�! ".��' ���� �� �� � ����� ������� �� & ���.� ��6��"� ��%% )77�)% ) ��!��)*5� �8 ����)�&.��� )*! .�)%". &)�� 7��8�����*)%� �.�)�� ���* "� �97)*! ".��� �*��%�!5� �*"� ".� �)7�!%$!���%�7�*5 )��) �8 .��#)% 4�!�&�*��� �" )77��9�+4)"�%$ 0�' ".�� "�9" �� ��)��*)#%$ 7��&�! 8�� ) �7�&�)+%��" ��%,4��

���> � (� ��-���

#��������� �� 1�.��"������� �������� ���"�"�"�

�(��.���� $��%����"� & ����� ���� .����) ,��"�� ��

���� �������?.,7����

-�%� L22+�+0�2+<���0< �- �� � �����@)9� L22+�+0�2+<����E ���� "��" �� � ,�� �������"�� +4)�%� �"����&,��)*M�7&.+"��*��".$�*.��,� �� �� $��") 7�� ��� ���"�

��*�8� �73 9��) $����� �������?.,7���<

��� ���� � ����

�7$��5." � ���� (�.* /�%�$ C ��*�' �"!� ��� ����������� � �� �� ����� ��� ��������