•Explain the diagnostic criteria for your assigned neurocognitive disorder.
•Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned neurocognitive disorder.
•Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks.
•Support your rationale with references to the Learning Resources or other academic resource. Major Neurocognitive Disorder with Lewy Bodies Essay
Major Neurocognitive Disorder with Lewy Bodies
The diagnostic criteria for likely major neurocognitive disorder with Lewy bodies necessitate the presence of dementia; shifting concentration and attention; recurring visual hallucinations, and unprompted parkinsonian motor signs. Indicative clinical features of major neurocognitive disorder with Lewy bodies include serious neuroleptic sensitivity; Rapid eye movement (REM) sleep behavior disorder; and low dopamine transporter uptake from PET imaging (McKeith et al, 2017).
Sleep hygiene: Sleep hygiene can be used to treat sleep problems in individuals with Major Neurocognitive Disorder with Lewy Bodies. This is because this condition normally causes serious sleep problems, including excessive daytime sleeping. Sleep hygiene can include activities such as avoiding long and regular daytime naps and avoiding alcohol intake or taking caffeine late in the day (Chan et al, 2018).
Electroconvulsive therapy (ECT): This is electrically stimulating the brain. ECT has been widely utilized in treating agitation in major neurocognitive disorder with Lewy due to the significant functional impairment and distress that the condition causes. Agitation in major neurocognitive disorder with Lewy can make it very hard to care for individuals do to potential self-harm and harm for others. Electroconvulsive therapy has been shown to be effective in treating agitation in dementia (Connors et al, 2018).
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Galantamine: Galantamine can be used to improve symptoms such as cognitive fluctuations, sleep problems, and well as psychiatric symptoms such as hallucinations and anxiety. Major Neurocognitive Disorder with Lewy Bodies Essay
Memantine: Memantine is used in treating behavioral symptoms in people with Major Neurocognitive Disorder with Lewy Bodies and also decrease deterioration of the brain, especially in a patient with mild/moderate Major Neurocognitive Disorder with Lewy Bodies. In addition, memantine has been shown to improve cognition, perception disorders as well as motor skills (Persoons, 2016). The medication has also been shown to be effective in treating REM sleep behavior disorder. However, potential cognitive benefits of memantine should be evaluated against the medications likely side effects such as nausea, fatigue, vomiting, dizziness, fainting, headache, joint pain, etc (Persoons, 2016). Major Neurocognitive Disorder with Lewy Bodies Essay
Rivastigmine: This is a cholinesterase inhibitor that is effective in reducing degradation of choline because cholinergic deficits are a common and major cause of cognitive deficits in DLB. Rivastigmine can be effective in improving cognitive function, global function and also functioning ability (Chan et al, 2018).
Memantine is associated with side effects such as nausea, fatigue, vomiting, dizziness, fainting, headache, joint pain, and constipation. These side effects can be minimized by administering a tolerable dose and also by balancing the potential benefits of the medications against the potential side effects (Buckley & Salpeter, 2015).
Rivastigmine and galantamine are associated with side effects such as gait, fall, as well as adverse events associated with falls. These potential risks can be prevented by closely monitoring the patients while they are taking these medications (Nakagawa et al, 2017). This will significantly reduce the risk of falls.
Buckley J & Salpeter S. (2015). A Risk-Benefit Assessment of Dementia Medications: Systematic Review of the Evidence. Drugs Aging. 32(6),453-67.
Chan P, Lee H, Hong C, Hu C & Wu D. (2018). REM Sleep Behavior Disorder (RBD) in Dementia with Lewy Bodies (DLB). Behavioral Neurology. 1(2018), 1-10.
Connors M, Lena Q, Ian M, Allan L, Thomas A, Taylor J & John O. (2018). Non-pharmacological interventions for Lewy body dementia: a systematic review. Psychol Med. 48(11), 1749–1758.
McKeith I, Boeve B, Dickson D, Taylor J, Dag A, Beach T, Blanc F et al. (2017). Diagnosis and management of dementia with Lewy bodies. Neurology. 89(1), 88–100.
Nakagawa R, Takashi O, Toshio Y, Ai T, Kato T & Yoshizawa K. (2017). The long-term effect of galantamine on cognitive function in patients with Alzheimer’s disease versus a simulated disease trajectory: an observational study in the clinical setting. Neuropsychiatr Dis Treat. 1(13), 1115–1124.
Persoons V. (2016). Early use of memantine in the treatment of Lewy body dementia]. Tijdschr Psychiatr. 58(11), 814-817. Major Neurocognitive Disorder with Lewy Bodies Essay