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Interaction between psychological and pharmacological treatment in cognitive impairment

Deberdt W.

UCB Pharma, 
Chemin du Foriest, Braine-l'Alleud, Belgium.
Life Sci 1994;55(25-26):2057-2066

ABSTRACT

In contrast to other kinds of psychotropic drugs, nootropics or cognition enhancing drugs may be indicated, not for the direct treatment of the pathology itself, but for improving or restoring the remaining brain functions. Brain functions are normally trained during various kinds of non-medical therapy, such as physiotherapy, speech therapy, occupational therapy, memory training etc. In research little attention has been paid to the combination of both kinds of therapeutic approaches, probably because of the important methodological difficulties. This combination however, offers various interesting perspectives: L. ISRAEL examined in two placebo-controlled studies the effects of either 160 mg/d of ginkgo biloba extractum (GBE) or piracetam 2.4 or 4.8 g/d, combined with a memory training program, in nondemented patients complaining of memory problems. The results of both studies suggest that nootropic drug treatment and memory training have each an effect on different cognitive functions and, hence, are complementary. Some functions, like attention/perception in the GBE study and learning in the piracetam study, seem to benefit from both treatments, suggesting a mutually potentiating effect of drug treatment and training. This potentiation is very clear in the treatment of dyslexic children: in a placebo-controlled study piracetam 3.3 g/d, in combination with normal school teaching and more specific logopedic therapy, allowed a normal progression during the full school year in reading accuracy and reading comprehension, while the placebo treated children getting a similar training progressed only with 50%. Recently promising results were obtained in the treatment of dysphasic patients with a combination of speech therapy and piracetam 4.8 g/d, especially when given during the first months after the stroke, or otherwise in combination with an intensive speech training. In both double-blind studies the piracetam treated group improved about 60% more than the group who only got speech therapy and placebo. All these data may be explained by the restorative or enhancing influence of nootropic drugs on neurotransmitter systems closely related to learning and memory functions. E.g. piracetam restores the availability and function of muscarinic and NMDA receptors in aging animals, most probably through a modulation of the psychico-chemical properties of the neuronal membrane such as the membrane fluidity.

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   Alzheimer's                                                                                         
piracetam  Alzheimer's study
piracetam  controlled study with dementia syndrome
piracetam  induced EEG changes in Alzheimer's
piracetam  effect on cerebral metabolism in Alzheimer's
piracetam  reverses hippocampal changes in Alzheimer's
piracetam  use in Alzheimer's
piracetam  effect on senile dementia memory
   Alcoholism
piracetam  alcoholic treatment
piracetam  efficacy in chronic alcoholics
piracetam  effect on alcoholics
piracetam  in acute alcohol withdrawal
   Brain injury
piracetam  effect on consciousness due to head injury
piracetam  protection in brain injury
piracetam  use in severe brain injury
piracetam  and concussion
   Circulatory disorders
piracetam  effectiveness in cerebral arteriosclerosis
piracetam  and chronic cerebrovascular disorders
piracetam  effect on brain circulation failure
   Deafness
piracetam  use in sudden deafness
piracetam  sudden hearing loss treatment
piracetam  in tinnitus and sudden deafness
piracetam  treatment of sudden deafness
   Dyslexia
piracetam  verbal effect in dyslexic boys
piracetam  efficacy in dyslexic reading and writing disorders
piracetam  improves reading in dyslexia
piracetam  learning aid in dyslexia
piracetam  effects on developmental dyslexia
piracetam  in students with dyslexia
piracetam  in children with dyslexia
   Heart Disease
piracetam  in ischemic heart disease
piracetam  effects on arterial hypertension
piracetam  effect on elderly coronary heart disease
piracetam  in chronic ischemic heart disease
piracetam  in ischemic heart disease
piracetam  in myocardial infarct patients
   Mental Function
piracetam  in patients with mental decline
piracetam  effects on cognitive functions
piracetam  efficacy in cognitive impairment
piracetam  in cerebral impairment
piracetam  study age-related memory disorders
piracetam  a trial on memory impairment
piracetam  interaction in the motor cortex
piracetam  effects on human EEG
piracetam  and EEG of boys with learning disorders
piracetam  effect on adolescent brain function
piracetam  in elderly cerebral impairment
piracetam   changes brain function
piracetam  effects on brain functions
   Stroke
piracetam  improves blood flow of post-stroke patients
piracetam  in secondary stroke prophylaxis
piracetam  treatment of acute and chronic aphasia
piracetam  in the treatment of acute stroke
piracetam  evaluation in acute stroke
piracetam  in stroke-unduced Aphasia
piracetam  treatment in ischemic stroke
piracetam  treatment of patients with an ischemic stroke
piracetam  acute stroke study
piracetam  effect on post-stroke recovery
piracetam  adjuvant to language therapy for aphasia
piracetam  effect on cerebral infarction in stroke patients
   Sickle cell disease
piracetam  treatment of children with sickle cell disease
piracetam  improves sickle cell deformability
piracetam  crises management of sickle cell disease
   Child birth
piracetam  in parturients and newborn infants
piracetam  reduced duration of labor
piracetam  protective effect during delivery
piracetam  concentrations during delivery
   Myoclonus
piracetam  promising results in myoclonus epilepsy
piracetam  long-term efficacy in myoclonus epilepsy
piracetam  beneficial use for severe myoclonus epilepsy
piracetam  and progressive myoclonus epilepsy
piracetam  in patients with myoclonus
piracetam  relieves symptoms in progressive myoclonus epilepsy
piracetam  in cortical myoclonus
piracetam  beneficial effect on post-ischaemic myoclonus
   Raynaud's
piracetam  treatment of Raynaud's
piracetam  evidence for its anti-platelet effect in Raynaud's
piracetam  platelet anti-aggregant properties
   Vertigo
piracetam  treatment for vertigo
piracetam  is effective in vertigo
piracetam  effect in 55 vertigo patients
piracetam  subjective improvement in vertigo
piracetam  significantly reduced vertigo symptoms
   Misc.
piracetam  efficacy in breath-holding spells
piracetam  mechanism of action
piracetam  elevates cholinergic receptor density  
piracetam  cholinergic receptor function in mice
piracetam  effect on cerebral glucose utilization
piracetam  improved driving in elderly motorists
piracetam  and nootropics
piracetam  auxiliary treatment of cerebral palsy
piracetam  unique mode of action
piracetam  psychological and pharmacological treatment
piracetam  improves cholinergic system efficiency
piracetam  and vigilance
piracetam  versus acetylcholinesterase inhibitors
piracetam  therapy in recurrent duodenal ulcer
piracetam  efficacy in recurrence of duodenal ulcer
piracetam  treatment of soft tissue rheumatism 
piracetam  effect on intellectually deficient children
piracetam  effect on neuroleptic-induced side effects
piracetam  improved school-performance in legasthenia
piracetam  effect on consciousness after neurosurgery

  
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