Amnesia medical therapy: Difference between revisions

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{{Amnesia}}
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==Overview==
==Overview==
Treatment can be offered in cases of reversible conditions. If not, provision of supportive care can help to improve a patient's condition.
[[Treatment]] can be offered in cases of reversible conditions. If not, provision of supportive care can help to improve a [[patient's]] condition. [[Etiology]] specific [[treatment]] plan should be followed to improve [[memory]] and delay [[progression]].


==Medical Therapy==
==Medical Therapy==
Memory loss can't be treated unless it is caused by a reversible condition. The treatment is greatly dependent on the primary cause of the condition. When memory loss is a symptom of a more severe disease, it may be reversed as soon as the underlying condition is identified and cured. Memory loss due to aging cannot be cured, but the symptoms may be improved by following the preventative measures.
*[[Memory]] loss can't be treated unless it is caused by a reversible condition.  
 
*The [[treatment]] is greatly dependent on the primary [[etiology]].
Family support plays an important role in treating memory loss. Family members are usually encouraged to take special orientation classes on how to cope with their sick relatives and how to help them improve their condition.
*When [[memory]] loss is a [[symptom]] of a more severe [[disease]], it may be reversed as soon as the underlying condition is identified and cured.  
===Dissociative or Functional or Psychogenic Amnesia===
*[[Memory]] loss due to [[aging]] cannot be cured, but the symptoms may be improved by [[preventative]] measures.<ref name="pmid22013901">{{cite journal| author=Mendelsohn AR, Larrick JW| title=Reversing age-related decline in working memory. | journal=Rejuvenation Res | year= 2011 | volume= 14 | issue= 5 | pages= 557-9 | pmid=22013901 | doi=10.1089/rej.2011.1247 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22013901  }} </ref>
Currently, various treatments are available for patients with psychogenic amnesia although no well-controlled studies on the effectiveness of different treatments exist.
*Family support plays an important role in treating [[memory]] loss.  
*[[Psychoanalysis]] -uses dream analysis, interpretation and other psychoanalytic methods to retrieve memories; may also involve placing patients in threatening situations where they are overwhelmed with intense emotion.<ref name = Brandt>{{cite journal |author=Brandt J, Van Gorp WG |title=Functional ("psychogenic") amnesia |journal=Semin Neurol |volume=26 |issue=3 |pages=331–40 |year=2006 |pmid=16791779 |doi=10.1055/s-2006-945519}}</ref>  
*Family members are usually encouraged to take special orientation classes on how to cope with their sick relatives and how to help them improve their condition.<ref name="pmid19689239">{{cite journal| author=Austrom MG, Lu Y| title=Long term caregiving: helping families of persons with mild cognitive impairment cope. | journal=Curr Alzheimer Res | year= 2009 | volume= 6 | issue= 4 | pages= 392-8 | pmid=19689239 | doi=10.2174/156720509788929291 | pmc=2862360 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19689239  }} </ref>
*[[Medication]] and [[relaxation technique]]s - in conjunction with [[benzodiazepine]]s and other hypnotic medications, the patient is urged to relax and attempt to recall memories.<ref name = Brandt/> With the help of psychotherapy and learning their autobiographies from family members, most patients recover their memories completely.
*'''[[Post-traumatic Amnesia]]''':<ref name="pmid22865461">{{cite journal| author=Wortzel HS, Arciniegas DB| title=Treatment of post-traumatic cognitive impairments. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 5 | pages= 493-508 | pmid=22865461 | doi=10.1007/s11940-012-0193-6 | pmc=3437653 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22865461  }} </ref>
*It has been proposed that [[abreaction]] could be used in conjunction with [[midazolam]] to recover memories. This technique was used during World War II but is currently much less popular. The technique is thought to work either through depressing the function of the [[cerebral cortex]] and therefore making the memory more tolerable when expressed, or through relieving the strength of an emotion attached to a memory which is so intense it suppresses memory function.<ref>{{cite journal | last = Vattakatuchery | first = JJ | coauthors = Chesterman, P | journal = Journal of Forensic Psychiatry and Psychology | url = http://www.informaworld.com/smpp/432725912-4932359/content~content=a759276300~db=all~order=page | title = The use of abreaction to recover memories in psychogenic amnesia: A case report | volume = 17 | issue = 4 | pages = 647–653 | accessdate = 2007-12-05 | year = 2006 | doi = 10.1080/14789940600965938}}</ref>
**Supportive: Environmental and lifestyle modifications, [[cognitive]] [[rehabilitation]].
*Some studies about psychogenic amnesia have concluded that [[psychotherapy]] is not connected to recovered memories of child sexual abuse.<ref name=dissoc-9-4>{{cite journal|title=Memory recovery of childhood sexual abuse |last=Albach |first=Francine |coauthors=Peter Paul Moormann, Bob Bermond |journal=Dissociation |volume=Vol. 9, No. 4, p. 261-273 |url=http://hdl.handle.net/1794/1774 |date=Dec-1996 |accessdate=2008-01-03 |issn=0896-2863}}</ref><ref name=chu>{{cite journal |author=Chu JA, Frey LM, Ganzel BL, Matthews JA |title=Memories of childhood abuse: dissociation, amnesia, and corroboration |journal=Am J Psychiatry |volume=156 |issue=5 |pages=749–55 |year=1999 |pmid=10327909 |doi= | url = http://ajp.psychiatryonline.org/cgi/content/full/156/5/749 }}</ref> Data suggests that one’s amnesic recovered memory is spontaneous, and that this is triggered by abuse-related stimuli.<ref name=dissoc-9-4/>
**[[Pharmacological]]: In early post-[[trauma]] stage, [[drugs]] that [[stimulate]] [[cerebral]] [[acetyl cholinergic]] functions may be used to improve [[memory]]. In late stages [[drugs]] with [[cerebral]] [[catecholaminergic]] function may be beneficial to improve attention, information processing speed and time, and decrease development of [[depression]] and [[apathy]].
 
*'''Dissociative Amnesia''':
===Dissociative Fugue===
**[[Psychotherapy]]: [[Cognitive-behavioral therapy]], [[dialectic-behavior therapy]], relaxation techniques.
The goal of treatment is to help the person come to terms with the stress or trauma that triggered the fugue. Treatment also aims to develop new coping methods to prevent further fugue episodes. The best treatment approach depends on the individual and the severity of his or her symptoms, but most likely will include some combination of the following treatment methods:
**[[Medications]]: [[Antidepressants]], [[anti-anxiety]] or [[antipsychotic]] [[drugs]] are used to treat the mental [[symptoms]] associated with [[dissociative amnesia]].
*[[Psychotherapy]]<ref>[http://www.pep-web.org/document.php?id=PI.020.0259A The Psychoanalytic Psychotherapy of Dissociative Identity Disorder in the Context of Trauma Therapy ( Psychoanalytic Inquiry, 2000 )]</ref><ref> [http://www.ipa.org.uk International Psychoanalytical Association (IPA)]</ref> — Psychotherapy, a type of counseling, is the main treatment for dissociative disorders. This treatment uses techniques designed to encourage communication of conflicts and increase insight into problems.
*'''[[Childhood Amnesia]]''': Methods used from retrieval of episodic memory lost:
*[[Cognitive therapy]] — This type of therapy focuses on changing dysfunctional thinking patterns and resulting feelings and behaviors.
**Cued recall: [[Patients]] are prompted to recall memories co-relating to the cue word.<ref name="pmid23937179">{{cite journal| author=Bauer PJ, Larkina M| title=Childhood amnesia in the making: different distributions of autobiographical memories in children and adults. | journal=J Exp Psychol Gen | year= 2014 | volume= 143 | issue= 2 | pages= 597-611 | pmid=23937179 | doi=10.1037/a0033307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23937179  }} </ref>
*[[Psychiatric medication|Medication]] — There is no medication to treat the dissociative disorders themselves. However, a person with a dissociative disorder who also suffers from depression or anxiety might benefit from treatment with a medication such as an antidepressant or anti-anxiety medicine.
**Free recall: Patient is free to recall memories in any order.
*[[Family therapy]] — This helps to teach the family about the disorder and its causes, as well as to help family members recognize symptoms of a recurrence.  
**Exhaustive recall: Memory recall of all the incidents prior to a specific age without using a cue.<ref name="pmid17654279">{{cite journal| author=Jack F, Hayne H| title=Eliciting adults' earliest memories: does it matter how we ask the question? | journal=Memory | year= 2007 | volume= 15 | issue= 6 | pages= 647-63 | pmid=17654279 | doi=10.1080/09658210701467087 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17654279  }} </ref>
*Creative therapies (art therapy, [[music therapy]]) — These therapies allow the patient to explore and express his or her thoughts and feelings in a safe and creative way.
*'''Drug Induced Amnesia''':
*[[Hypnotherapy|Clinical hypnosis]] — This is a treatment method that uses intense relaxation, concentration and focused attention to achieve an altered state of consciousness (awareness), allowing people to explore thoughts, feelings and memories they might have hidden from their conscious minds. The use of hypnosis for treating dissociative disorders is controversial due to the risk of creating false memories.
**It is reversed once the drug administration stops. Although, some memory right after onset of memory loss due to drug intake could be permanently lost but the rest of the memory is regained.<ref> Sadock, Benjamin J., and Virginia A. Sadock. Kaplan & Sadock's concise textbook of clinical psychiatry. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2008. Print</ref>
*'''Korsakoff's syndrome''':
**[[Thiamine]] replacement: IV 500 mg- 1500 mg, thrice a daily 3 days at the minimum.
**[[Electrolyte]] and [[fluid]] replacement. [[Magnesium]] and [[glucose]] administration is crucial, if deficient.<ref name="pmid22104258">{{cite journal| author=Schabelman E, Kuo D| title=Glucose before thiamine for Wernicke encephalopathy: a literature review. | journal=J Emerg Med | year= 2012 | volume= 42 | issue= 4 | pages= 488-94 | pmid=22104258 | doi=10.1016/j.jemermed.2011.05.076 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22104258  }} </ref>
**[[Memory]] [[rehabilitation]]<ref name="pmid26047664">{{cite journal| author=Oudman E, Nijboer TC, Postma A, Wijnia JW, Van der Stigchel S| title=Procedural Learning and Memory Rehabilitation in Korsakoff's Syndrome - a Review of the Literature. | journal=Neuropsychol Rev | year= 2015 | volume= 25 | issue= 2 | pages= 134-48 | pmid=26047664 | doi=10.1007/s11065-015-9288-7 | pmc=4464729 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26047664  }} </ref>
*'''Alzheimers Disease''':<ref name="pmid27547756">{{cite journal| author=Mendiola-Precoma J, Berumen LC, Padilla K, Garcia-Alcocer G| title=Therapies for Prevention and Treatment of Alzheimer's Disease. | journal=Biomed Res Int | year= 2016 | volume= 2016 | issue=  | pages= 2589276 | pmid=27547756 | doi=10.1155/2016/2589276 | pmc=4980501 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27547756  }} </ref>
**[[Cholinesterase inhibitors]] and [[memantine]] are commonly used to improve [[cognitive]] [[symptoms]].
*'''Epileptic Amnesia'''
**Usually resolves with [[anti-epileptic]] [[medications]].<ref name="pmid21262589">{{cite journal| author=Walsh RD, Wharen RE, Tatum WO| title=Complex transient epileptic amnesia. | journal=Epilepsy Behav | year= 2011 | volume= 20 | issue= 2 | pages= 410-3 | pmid=21262589 | doi=10.1016/j.yebeh.2010.12.026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21262589  }} </ref>


==References==
==References==

Latest revision as of 02:18, 25 March 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

Treatment can be offered in cases of reversible conditions. If not, provision of supportive care can help to improve a patient's condition. Etiology specific treatment plan should be followed to improve memory and delay progression.

Medical Therapy

References

  1. Mendelsohn AR, Larrick JW (2011). "Reversing age-related decline in working memory". Rejuvenation Res. 14 (5): 557–9. doi:10.1089/rej.2011.1247. PMID 22013901.
  2. Austrom MG, Lu Y (2009). "Long term caregiving: helping families of persons with mild cognitive impairment cope". Curr Alzheimer Res. 6 (4): 392–8. doi:10.2174/156720509788929291. PMC 2862360. PMID 19689239.
  3. Wortzel HS, Arciniegas DB (2012). "Treatment of post-traumatic cognitive impairments". Curr Treat Options Neurol. 14 (5): 493–508. doi:10.1007/s11940-012-0193-6. PMC 3437653. PMID 22865461.
  4. Bauer PJ, Larkina M (2014). "Childhood amnesia in the making: different distributions of autobiographical memories in children and adults". J Exp Psychol Gen. 143 (2): 597–611. doi:10.1037/a0033307. PMID 23937179.
  5. Jack F, Hayne H (2007). "Eliciting adults' earliest memories: does it matter how we ask the question?". Memory. 15 (6): 647–63. doi:10.1080/09658210701467087. PMID 17654279.
  6. Sadock, Benjamin J., and Virginia A. Sadock. Kaplan & Sadock's concise textbook of clinical psychiatry. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2008. Print
  7. Schabelman E, Kuo D (2012). "Glucose before thiamine for Wernicke encephalopathy: a literature review". J Emerg Med. 42 (4): 488–94. doi:10.1016/j.jemermed.2011.05.076. PMID 22104258.
  8. Oudman E, Nijboer TC, Postma A, Wijnia JW, Van der Stigchel S (2015). "Procedural Learning and Memory Rehabilitation in Korsakoff's Syndrome - a Review of the Literature". Neuropsychol Rev. 25 (2): 134–48. doi:10.1007/s11065-015-9288-7. PMC 4464729. PMID 26047664.
  9. Mendiola-Precoma J, Berumen LC, Padilla K, Garcia-Alcocer G (2016). "Therapies for Prevention and Treatment of Alzheimer's Disease". Biomed Res Int. 2016: 2589276. doi:10.1155/2016/2589276. PMC 4980501. PMID 27547756.
  10. Walsh RD, Wharen RE, Tatum WO (2011). "Complex transient epileptic amnesia". Epilepsy Behav. 20 (2): 410–3. doi:10.1016/j.yebeh.2010.12.026. PMID 21262589.

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