Pick's disease, also called frontotemporal dementia, is a rare genetic disorder and form of dementia that most often affects individuals younger than sixty-five years old. Typically, the condition affects behavior, personality, judgment, and language skills. Symptoms include drastic mood swings, repetitive behaviors, social withdrawal and isolation, depression, lack of empathy, and being impulsive. A definitive diagnosis of this disease is made through blood tests, neurological examinations, brain scans, speech tests, and interviews with family members. The average life expectancy is between two to seven years after diagnosis, and some individuals live for a decade. Pick's disease cannot be cured, and treatments are used to manage symptoms. The interventions described below can help Pick's disease patients improve their quality of life.
Antidepressants help reduce the aggression, irritability, loss of interest, and withdrawal that are common with Pick's disease. They can benefit patients by calming them and flattening out mood swings so they are less drastic. For patients with Pick's disease, doctors typically choose to start with drugs known as selective serotonin reuptake inhibitors (SSRIs). SSRIs are a type of antidepressant that increases levels of the hormone serotonin in the brain. Citalopram, fluvoxamine, sertraline, and fluoxetine are SSRIs patients generally tolerate well. Possible side effects include fatigue, dry mouth, nausea, and dizziness. Patients taking antidepressants should be monitored closely by their doctors for any mood changes or suicidal thoughts. Occasionally, they may cause a fast heartbeat, and any cardiac concerns should be reported to the healthcare professional who put the patient on the medication originally.
When switching from one antidepressant to another, adding additional antidepressants to an active treatment regimen, or stopping an antidepressant, patients and their doctors should work together to taper the dosages on a gradual schedule. Discontinuing an antidepressant suddenly can result in unpleasant withdrawal symptoms such as vivid dreams, insomnia, muscle aches, chills, tingling sensations, and a recurrence of depression symptoms.
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Like antidepressants, antipsychotic medications can help Pick's disease patients by calming them. In fact, many antipsychotic medications have a sedating effect, and they are also helpful in stabilizing mood, reducing mania, impulsive behavior, and aggression. Some of the most commonly used antipsychotics include aripiprazole, cariprazine, lurasidone, and risperidone. Side effects are similar to those of antidepressants and include drowsiness, dizziness, weight gain, constipation, increased blood sugar, and blurred vision. Severe side effects, such as muscle spasms, seizures, fainting, and fever may occur, and these should be reported to a doctor promptly. Sometimes, several antipsychotic medicines may be used at one time to provide better symptom control. Patients who are on a combined drug regimen should be monitored very closely by their medical team. If some antipsychotics cause intolerable side effects, other forms of medication can be tried.
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Treatment For Anemia
Anemia, a medical condition characterized by a low red blood cell count, often occurs in Pick's disease patients. Anemia can interfere with quality of life and may make patients feel too weak to engage in activities. The most common symptoms include fatigue and pale skin. This condition is usually temporary for most patients and can be detected with a blood test called a complete blood count. Iron and vitamin B12 deficiencies most often cause anemia. More serious forms of anemia such as aplastic anemia, sickle cell anemia, and hemolytic anemia result from chronic underlying diseases. Depending on the type of anemia that is diagnosed, appropriate treatment may be as simple as taking oral iron supplements or receiving injections of vitamin B12. In more serious cases, blood transfusions or bone marrow transplants may be needed to correct this condition.
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Appropriate nursing care is essential to manage the later stages of Pick's disease. Patients with this form of dementia will need assistance with personal hygiene, self-care, and daily tasks such as dressing, brushing teeth, cooking, and eating meals. They may become confused and disorientated to such a degree that they cannot remember where they are, which can be frightening for the patient and their family. While home health nurses and in-home caregivers may be able to provide suitable assistance in the early stages of the illness, the disease will eventually progress to the point twenty-four-hour care is needed. At this stage, the patient is often moved to a specialist nursing home with a dementia care or memory care facility. Patients who have been recently diagnosed with Pick's disease should discuss living wills, advance directives, power of attorney, and other legal and financial matters with their family members as soon as possible. Patients and their families may also wish to search for home health care aides and research nursing facilities soon after receiving a diagnosis.
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Treatment For Nutritional Deficiencies
Nutritional deficiencies are quite common in Pick's disease patients and can result from many causes including medications and the symptoms themselves. For example, Pick's patients generally experience confusion, disorientation, irritability, aggression, and depression. These may all lead to loss of appetite and an inability to eat a balanced diet. Patients simply may not wish to eat, and in the later stages of Pick's disease, they may forget how to feed themselves. Treatment for nutritional deficiencies can help these patients have a higher quality of life for as long as possible. Blood tests can be performed to identify the specific deficiencies. Treatments include supplements and nutritionally balanced meal replacement shakes or bars. As the disease progresses, doctors can monitor patients nutritional status and may recommend intravenous or tube feeding. Particularly in the early stages of Pick's disease, loved ones and caregivers can help patients by cooking higher calorie versions of the patient's favorite foods and encouraging them to eat plenty of fruits and vegetables. If needed, fruits and vegetables can be blended up into smoothies or soups to make them easier to swallow.