An Agitated Patient With COVID-19 Infection and Early-onset Alzheimer Disease.


Journal

Alzheimer disease and associated disorders
ISSN: 1546-4156
Titre abrégé: Alzheimer Dis Assoc Disord
Pays: United States
ID NLM: 8704771

Informations de publication

Date de publication:
Historique:
received: 13 12 2020
accepted: 01 04 2021
pubmed: 12 5 2021
medline: 3 3 2022
entrez: 11 5 2021
Statut: ppublish

Résumé

Encephalopathy, delirium, and agitation are documented symptoms of coronavirus disease (COVID-19) infection, but research into the management of agitation in the setting of COVID-19 and pre-existing neuropsychiatric disease is ongoing. We present a 55-year-old male patient with early-onset Alzheimer disease and deteriorating mental and functional status who presented to our institution with agitation and persistent COVID-19 positivity on polymerase chain reaction testing. His agitation was improved through pharmacologic optimization including the avoidance of benzodiazepines and initiation of clonidine and prazosin, which temporally coincided with the resolution of his nearly 2-month long COVID-19 positivity.

Identifiants

pubmed: 33973880
doi: 10.1097/WAD.0000000000000456
pii: 00002093-202201000-00013
pmc: PMC8876388
doi:

Substances chimiques

Benzodiazepines 12794-10-4

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

83-84

Informations de copyright

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

Références

Ellul MA, Benjamin L, Singh B, et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19:767–783.
Cabrera MA, Karamsetty L, Simpson SA. Coronavirus and its implications for psychiatry: a rapid review of the early literature. Psychosomatics. 2020;61:607–615.
Wang H, Li T, Barbarino P, et al. Dementia care during COVID-19. Lancet. 2020;395:1190–1191.
Porsteinsson AP, Drye LT, Pollock BG, et al. Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA. 2014;311:682–691.
Bilbul M, Paparone P, Kim AM, et al. Psychopharmacology of COVID-19. Psychosomatics. 2020;61:411–427.
Baller EB, Hogan CS, Fusunyan MA, et al. Neurocovid: pharmacological recommendations for delirium associated with COVID-19. Psychosomatics. 2020;61:585–596.
Brigham and Women’s Hospital. Brigham and Women’s Hospital COVID-19 clinical guidelines. 2020. Available at: https://covidprotocols.org/ . Accessed November 30, 2020.
Gubbi S, Nazari MA, Taieb D, et al. Catecholamine physiology and its implications in patients with COVID-19. Lancet Diabetes Endocrinol. 2020;8:978–986.
Johns Hopkins University. Prazosin to prevent COVID-19 (PREVENT-COVID Trial) (PREVENT). NIH Clinical Trials. 2020. Available at: https://www.clinicaltrials.gov/ct2/show/NCT04365257 . Accessed November 30, 2020.
Wang LY, Shofer JB, Rohde K, et al. Prazosin for the treatment of behavioral symptoms in patients with Alzheimer disease with agitation and aggression. Am J Geriatr psychiatry Off J Am Assoc Geriatr Psychiatry. 2009;17:744–751.

Auteurs

Daniel Sykora (D)

Mayo Clinic Alix School of Medicine.

Cynthia M Stonnington (CM)

Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, AZ.

Neeta Jain (N)

Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, AZ.

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