Neurofarmacologia

IntroduzioneOgni libro ha una sua storia, che è utile condividere con i lettori.La necessità di rivedere appropriatezza, criteri di utilizzo, modalità prescrittive, contesti relazionali in neuropsicofarmacologia del paziente anziano è sentita da molti.Le risposte formative sistematiche e soprattutto multidisciplinari non sono frequenti; nasce così l’idea di un Corso Multidisciplinare di due giorni, organizzato dall’Associazione Italiana di Psicogeriatria, che ha ott enuto un significativo successo per numero di partecipanti, per il loro entusiasmo operativo, per l’alta competenza dei relatori intervenuti da tutta Italia.Da questo successo, l’idea di trasferire in un libro non gli atti del congresso, ma una nuova originale elaborazione dei contenuti, con qualche opportuno ampliamento e revisione. Gli autori si sono resi disponibili a sistematizzare ed aggiornare i loro contenuti; a loro riconosciamo la grande disponibilità e la notevole competenza, senza le quali questo libro non avrebbe visto la luce.Chi lo acquista vi trova condensate le informazioni criticamente riviste sulle principali strategie neuro-psico-farmacologiche nel paziente anziano: non è un libro solo per cultori in psicogeriatria, ma anche per chi desidera avere un riferimento operativo sulle principali aree che quotidianamente il medico si trova ad esplorare con il paziente anziano.Ci rendiamo perfettamente conto che non tutte le possibili aree d’intervento sono state coperte, ma questo risente delle storie personali (i libri di collaborazione sono frutto anche di amicizie) e di scelte strategiche. Allo stesso tempo, qualche possibile disomogeneità anche formale va letta come espressione del vivace dibattito culturale che caratterizza la vita dell’Associazione Italiana di Psicogeriatria, che costituisce di fatto l’incubatrice di questo volume.Siamo convinti che l’opera rappresenti un contributo originale con importanti ricadute nella pratica quotidiana e che potrà favorire il dibattito e la crescita culturale nell’ambito delle cure del paziente psicogeriatrico.Buona lettura!Carlo Serrati, Claudio Vampini, Marco Trabucchi e Diego de Leo

This concise, yet authoritative, clinical reference guide fulfils the needs of diverse clinicians, pharmacists and allied health professionals prescribing for Parkinson's disease and movement disorders in contemporary clinical practice. With chapters on newly approved drugs and their effects on motor and non-motor symptoms, information is also given on their use in particular populations including the elderly and patients with cognitive impairment. Each chapter includes pharmacological/biochemical rationale for drug use, a general guide to therapeutic use, pharmacokinetics, interaction profile, adverse effects, dosing and use, special population considerations, costs and value for money considerations, clinical vignette, a summary overview, and suggested reading. Ordered alphabetically and perfect for quick reference use, the guide is practical and essential for all prescribers with responsibility for patients with Parkinson's disease, including neurologists, geriatricians, internists, neurosurgeons, psychiatrists, family physicians, pharmacists as well as allied health professionals and resident, fellow, and student trainees in all related medical fields. This concise, yet authoritative prescriber's guide features coverage of newly approved drugs such as safinamide and opicapone, clearly detailing drug applications, indications, adverse effects, and pharmacokinetic interactions Designed to provide broad yet concise and authoritative information, this guide is able to support the diversity of Parkinson's disease and movement disorders prescribers in contemporary clinical practice from neurologists to geriatricians In full colour, the book covers 55 Parkinson's disease drugs in alphabetic order, with colour coded information within each section, to support quick reference use and effective guidance The book contains information on the cost of each drug, based on UK data Clinical vignettes are included, giving practical tools to promote optimal prescribing

"La tossina botulinica ha influenzato la terapia neurologica come nessun altra sostanza" ha affermato recentemente Wolfang Jost, famoso neurologo tedesco. In effetti da quando è iniziato l'impiego in campo clinico - non più di qualche decennio fa - le sue applicazioni sono andate ampliandosi, non sempre in maniera controllata, sicché spesso l'uso si è trasformato in abuso. Soprattutto nel campo labile e controverso, tra cura e consumo, della medicina estetica e ancor maggiormente della "medicina cosmetica". Quest'ultima più che al benessere sanitario del malato mira a ottenere il "bellessere" estetico del consumatore. La storia della scoperta del botulismo e del germe che produce la neurotossina responsabile di questo letale evento, l'evoluzione delle tappe che hanno portato a comprenderne l'utilità terapeutica, un'esauriente rassegna scientifica degli impieghi attuali e futuri, un'articolata riflessione antropologica, sociale ed etica degli usi e degli eccessi di questa "moda curativa" emergono chiaramente dai contributi multidisciplinari presenti nel libro, indirizzato, oltre che agli specialisti, anche a tutte le persone che desiderano conoscere e approfondire i problemi aperti e controversi dell'ambito sanitario odierno.

Emotional, behavioral, and neuropsychiatric conditions are common in individuals with intellectual disabilities (IDs), most notably epilepsy, aggression, self-injurious behaviors, and bipolar and other mood disorders. Despite the prevalence of such problems, there is a scarcity in the literature of reliable information on medical treatments for those with IDs. A Practitioner's Guide to Prescribing Antiepileptics and Mood Stabilizers for Adults with Intellectual Disabilities provides a detailed framework for prescribing for this challenging population. Featuring the most up-to-date information on factors that inform prescribing, the Guide addresses basic issues and controversies (e.g., the rift between evidence-based and personalized medicine) in treating adults with cognitive deficits. Clients' specific needs are emphasized in developing appropriate and effective pharmacological intervention for improved outcomes and quality of life. Drugs discussed in the Guide include carbamazepine, clonazepam, diazepam, ethosuximide, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, lithium, lorazepam, oxcarbazepine, phenobarbital, phenytoin, pregabalin, primidone, rufinamide, tiagabine, topiramate, valproate, and zonisamide. For each of these compounds, the guidelines cover: * Indications for use; relative and absolute contraindications.* Assessment during treatment; therapeutic drug monitoring; warning signs and symptoms for caretakers.* Dosage: administration; initial and maximum recommended dosage; modifications associated with drug-drug interactions, personal characteristics, and (where appropriate) genetic variations.* Adverse drug reactions: common, relatively uncommon, and potentially lethal, plus risk of metabolic syndrome.* Guidelines for discontinuation.* References, tables, and drug utilization reviews. A Practitioner's Guide to Prescribing Antiepileptics and Mood Stabilizers for Adults with Intellectual Disabilities is an indispensable decision-making reference for psychiatrists, neuropsychologists, psychopharmacologists, neurologists, internists, and clinical psychologists.

Since the first edition of this book was published in 1992, the number of pharmacological therapies available for treating neurological disorders has grown exponentially. This new edition brings the book fully up-to-date, and features PET scans to illustrate brain action, and new chapters on practical therapeutics and clinical trials.

The book focuses on drug discovery for psychiatric and neurological diseases, which is in a phase of explosive growth. Chapters are divided into two major sections. The first section presents fundamentals of drug discovery, highlighting the modern techniques and approaches of drug discovery in biotech and pharmaceutical companies. Specific aspects of brain diseases, such penetration of the blood-brain barrier, are addressed. The author pays particular attention to clinical proof-of-concept research. Discussion of drug discovery for the major nervous system diseases represents the second section of the book. Each chapter looks at a particular class of disease, beginning with a summary of current understanding of disease mechanism and treatment, followed by thorough discussion of novel targets and emerging drugs.

The thoroughly revised, updated Fifth Edition of this classic is the most comprehensive, current, and authoritative reference on all anticonvulsants available today. This edition features detailed profiles of newer drugs - including levetiracetam, oxcarbazepine, tiagabine, topiramate, and zonisamide - and new chapters on use of antiepileptic drugs in children and during pregnancy. Drugs are covered in alphabetical order and in an easy-to-follow format: mechanisms of action; chemistry, biotransformation, and pharmacokinetics; interactions; clinical efficacy and use; and, adverse effects. Coverage of clinical use includes nonepileptic and psychiatric disorders where appropriate. This edition has been trimmed to manageable size by shortening chapters on older, less frequently used drugs.

As more drugs are "designed," more research is being done, and substance abuse remains a serious international problem, this reference remains important to neurologic literature.

Aside from the usual updating of material, the major change in this edition is an extensive re-writing of the chapter on memory and learning to emphasize that genes that are involved in behaviour are not immutable but their expression can be modified by transcription factors. Thus, with respect to learning, that old question about which is more important, nature or nuture, genetics or environment, should be answered with the question, which leg is more important for walking, the left or the right?