Lou Mikuzuki, Yuma Aota, A. Toyofuku, Miho Takenoshita, T. Nagamine, T. Suga, Takeshi Watanabe, T. Tu
{"title":"An increase in corrected QT interval may indicate a good clinical response to amitriptyline in female patients with burning mouth syndrome","authors":"Lou Mikuzuki, Yuma Aota, A. Toyofuku, Miho Takenoshita, T. Nagamine, T. Suga, Takeshi Watanabe, T. Tu","doi":"10.31487/J.NNB.2018.10.005","DOIUrl":"https://doi.org/10.31487/J.NNB.2018.10.005","url":null,"abstract":"Burning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa in the absence\u0000of underlying causes. BMS patients can pose a therapeutic challenge to clinicians. Amitriptyline has been a\u0000first-line treatment for BMS and is known to prolong corrected QT interval (QTc) in a dose dependent\u0000manner. However, little is known about the QTc lengthening effect of amitriptyline at analgesic dosages.\u0000The objective of this study was to evaluate changes in QTc in female BMS patients treated with\u0000amitriptyline. We conducted a single-center retrospective observational study and evaluated 40 female BMS\u0000patients. The QTc interval did not show statistically significant increase with amitriptyline (p=0.1502).\u0000However, the change in QTc of amitriptyline-responders was significantly longer than that of nonresponders (p=0.0142). The change in QTc may be a non-invasive maker of clinical responses to\u0000amitriptyline in female BMS patients.","PeriodicalId":19179,"journal":{"name":"Neurology and Neurobiology","volume":"131 10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87204323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Tan, Chathuri Yatawara, Debby Ng, N. Kandiah
{"title":"Long-term Efficacy and Safety of Donepezil Dose Escalation for Patients with Alzheimer?s Disease in a Clinical Setting","authors":"Laura Tan, Chathuri Yatawara, Debby Ng, N. Kandiah","doi":"10.31487/j.NNB.2018.10.004","DOIUrl":"https://doi.org/10.31487/j.NNB.2018.10.004","url":null,"abstract":"Background: Donepezil is a routinely prescribed cognitive enhancer for patients with Alzheimer’s disease\u0000(AD), however the effectiveness and safety of long-term high doses remains largely unexplored.\u0000Objective: We investigated the long-term efficacy and safety of Donepezil dose escalation in reducing\u0000global cognitive decline for patients with AD in a clinical setting.\u0000Method: In a naturalistic, open-label, controlled study design, 71 mild to moderate AD patients from a\u0000tertiary clinic were prescribed Donepezil 5mg/day for 12 months (phase 1), while 9 AD patients received\u0000no treatment. Patients who showed limited benefits (N=30) with Donepezil 5mg/day were titrated up to\u000010mg/day for a subsequent 12 months (phase 2) and the remaining (N=41) patients continued on 5mg/day.\u0000The primary outcome was global cognition, indexed using the Mini-Mental State Examination (MMSE).\u0000Results: Phase 1 trends confirmed Donepezil 5mg/day was better than no treatment at reducing cognitive\u0000decline (p = .09, f=.18). Phase 2 trends indicated that for patients who showed limited response to Donepezil\u00005mg/day, Donepezil 10mg/day was more effective in reducing slope of cognitive decline (p = 0.13, f= .42).\u0000Additionally, the patients that were titrated up to 10mg/day had comparable treatment benefits to those\u0000patients that remained on 5mg/day during phase 2 (p = .32, f =.12). Side effects in the 10mg/day group were\u0000not significantly different from the side effects in the 5mg group (t (67)=-1.27, p=.21).\u0000Conclusion: Donepezil dose escalation in patients with AD is safe and may result in large noticeable effects\u0000on cognition, with effects comparable to patients who initially responded well to 5mg/day.","PeriodicalId":19179,"journal":{"name":"Neurology and Neurobiology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88239407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hidden Factors in Diagnosing Alzheimer’s Disease","authors":"Linda Maguire, Gary L. Kreps","doi":"10.15406/JNSK.2016.5.00176","DOIUrl":"https://doi.org/10.15406/JNSK.2016.5.00176","url":null,"abstract":"Diagnoses of Alzheimer’s, dementia and other mental health conditions using the “family history method”\u0000can often be inaccurate, biased and possibly ill-motivated. Definitive clinical testing and/or biological tests\u0000rarely exist for most mental illnesses. Even when tests (such as PET scans or excess Abeta42 in cerebral\u0000spinal fluid indicating presence of neuronal plaques, for example) and other suggestive biomarkers are\u0000\"positive\", there are often no outward cognitive-behavioural symptoms or symptomatic evidence associated\u0000with the alleged mental illness (and vice-versa). Furthermore, environmental stressors, dehydration and\u0000other fully curable illness and treatable issues such as urinary tract infections, delirium, drug interactions\u0000and insomnia can quickly create outward ‘false’ symptoms of mental illnesses, often mistaken for true\u0000mental health diagnoses. Therefore, a comprehensive consideration of ex parte narratives, experience,\u0000familiarity and also possible underlying motivations, of even the most well-meaning family members in the\u0000“family history method” of mental illness diagnoses, currently used by doctors and other professionals,\u0000should be revisited.","PeriodicalId":19179,"journal":{"name":"Neurology and Neurobiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88010070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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