Re: Letter from Ian Mc, MD

[Guest guest]

,

Thanks for posting about this. Mc's letter (half of which is provided

below) is a comment on a German case report where Clozaril and Sinemet were

successfully used to treat a patient with psychiatric symptoms.

I've posted more about the case report and Mc's letter here, for those

interested:

http://community.lbda.org/forum/viewtopic.php?p=16682

Robin

>

> Adjunct treatment with levodopa in a patient with dementia with Lewy bodies,

delusions and severe neuroleptic hypersensitivity syndrome: some comments

>

> Some patients with dementia with Lewy bodies (DLB) exhibit persistent

disturbing psychiatric symptoms or challenging behavior despite treatment with

cholinesterase inhibitors. Such patients pose one of the more difficult clinical

management problems faced in psychogeriatrics. Neuroleptics are quite rightly

avoided whenever possible and the cautious " start low/go slow " maxim, which most

clinicians apply when neuroleptics have to be used, often turns into a chronic

" stay low/get no (response) " situation. Memantine has recently been reported to

produce cognitive and global benefits but without any significant improvement in

psychiatric symptoms (Aarsland et al., 2009) and there are no other specific

treatment recommendations for this clinical scenario.

>

>

> http://tinyurl.com/ybz3c5b

>