Dementia

Dopamine

- Controls movement & aids the flow of information to the front of the brain

- linked to thought & emotion

- Low dopamine = Parkinson's disease, dec. movement, stiffness, tremors, shaking

- May play a role in schizophrenia or ADHD

Norepinephrine

- Important in emotional arousal, attention,stress, anxiety, & mood disorders (depression, ADHD)

- Released during stress; has role in anxiety responses assoc. w/ drug dependence

Serotonin (5-HT)

- Controls functions, such as mood, appetite, & sleep

- lower levels are correlated with depression

- depression meds aim to block reuptake of serotonin

Glutamate

- An excitatory transmitter (Increases chance neuron will fire)

- Enhances electrical flow required for normal function; important role during early brain development

- Also involved in learning & memory

- Low Glu = mental disorders (autism, OCD, schizophrenia, Alzheimer's, depression)

GABA

- Most significant inhibitory NT

- Opens Cl- ion channels

- Targeted in epilepsy

- Drugs that affect GABA: Barbiturates, tranquilizers (Valium, Xanax), alcohol

Glycine

- immune response

- mood, cognition, pain perception

Acetylcholine

- binds to nicotinic & muscarinic receptors

- Sensory processing, attention and memory

- Low Ach in Dementia/Alzheimer's

Dementia

- Cognition: memory, language, orientation, judgement, planning

- Behavior: depression, anxiety, agitation, hallucinations, paranoia, aggression

- Other: weight loss, incontinence, gait disturbances, sleep disturbances

Goals of Treatment in Dementia

- Improve or preserve activities of daily living (ADL) function (improve/preserve cognitive & behavioral fxn)

- Reduce caregiver burden

- Enhance quality of life

- slow deterioration

- Manage psychiatric and behavioral symptoms

Glutamate in Dementia

- excessive Glu

- Synaptic NMDA needed for survival, but excess Glu dec. receptors

- Extrasynaptic NMDA Receptor activity promotes apoptosis => cell is overstimulated

DONEPEZIL (Aricept)

cholinesterase inhibitor for dementia tx (inc ACh)

MEMANTINE (Namenda)

NMDA glutamate receptor antagonist for dementia tx (dec. Glu signaling)