Aside from the fibromyalgia antidepressants, very few drug classes have evidence for efficacy in the treatment of fibromyalgia fatigue. There is some support for the use of antiepileptic drugs side effects. While the mechanisms of action of antiepileptic drugs are largely unknown, especially for the newest agents, it is believed that they reduce neuronal excitability anxiety, decrease ectopic neuronal discharge, and modulate the levels of a variety of neurotransmitters. (more…)

Fibromyalgia and myofascial pain (MP) are among the most common musculoskeletal disorders from which older adults suffer. These disorders represent opposite ends of the pain spectrum with the discrete character of myofascial pain at one extreme and the widespread symptoms of fibromyalgia at the other. Myofascial pain may be acute or chronic, and is associated with taut muscle bands and hypersensitive areas called trigger points. Fibromyalgia fatigue syndrome includes symptoms of fibromyalgia sleep disruption, fatigue, (more…)

Mounting evidence points to fibromyalgia as a heritable disorder. This evidence includes familial aggregation of fibromyalgia as well as a reduced pain threshold in the first-degree female relatives of fibromyalgia patients, even in those without overt clinical symptoms. Gene polymorphisms in the serotonergic dopaminergic neurons systems and a higher prevalence of polymorphisms in the promoter region of the serotonin transporter gene (5HTT) in fibromyalgia patients as compared to healthy controls also have been identified. (more…)

The principal reversible dementias are metabolic. Hypothyroidism and exposure to industrial or environmental toxins should be considered; iatrogenic cognitive impairment due to medications is a common example. Depending on the acuteness and intensity of the metabolic disturbance, the clinical presentation may be more similar to delirium than dementia. These dementias are reversible, but often not completely, depending on the length of exposure of the brain to the abnormal metabolic environment. (more…)

Depression is not a monolithic disorder. Rather, it presents in a variety of syndromes that may vary in severity, length, and association of depression with other symptoms. A number of ongoing controversies attend identification and differential diagnosis of depression in late life. This section considers three such issues: common clinical syndromes and diagnoses, major versus minor depressive syndromes, and the question of whether late-life depression is qualitatively different from depressive syndromes at younger ages. (more…)

The majority of older adults who suffer from depression experience lower-level symptoms that do not meet diagnostic criteria for major depressive disorder. The DSM recognizes several well-defined disorders that are considered minor depressive states. Dysthymia is defined as presence of one of the two defining symptoms plus at least two other symptoms of depression continuously for a period of at least 2 years. This chronic, low-level depression typically manifests relatively early in life and is in fact less prevalent in older than in younger persons. (more…)

You must understand that getting old is not an easy phase that our loved ones or the people that we know go through. Actually, everybody will age as time passes but each one will accept such a fate in different ways. But one thing that is the same, caring for older people should always be implemented and acted out. (more…)

It is now almost axiomatic that late-life depression is under detected, under diagnosed, and under treated. Although this basic fact has not changed, there has been tremendous progress over the past 10 years in ensuring that older adults with depressive disorders are in fact appropriately assessed, triaged, and provided adequate treatment for their symptoms. (more…)