No abstract

Disruptive nocturnal behavior, often referred to as sundowning, is a commonly encountered clinical problem in most forms of dementia. This study compared disruptive nocturnal behavior in patients with Alzheimer's disease (AD) and Parkinson's disease (PD). Questionnaire data were collected from 60 AD and 48 PD caregivers. Respondents were asked to record the typical time of day when any of seven disruptive behaviors were evidenced in their patients, if at all. Two scores were computed: (1) a sundowning score (number of nocturnal disruptive behaviors, range 0-7), and (2) a total score (number of disruptive behaviors without regard to time, range 0-7). Results indicated PD patients were more likely than AD patients to exhibit disruptive nocturnal behavior. The dose, timing, or number of years on antiparkinsonian medication were not related to nocturnal disruptive behavior within the PD patient group. These findings raise the possibility that sundowning in PD patients may be a manifestation of dopaminergic depletion within the basal ganglia or other abnormalities involving the cholinergic, serotoninergic and/or noradrenergic systems in the brainstem.

No abstract

The sedative and physiological effects of intravenous romifidine at 120 micrograms/kg were compared with intravenous romifidine (120 micrograms/kg) followed immediately by intravenous butorphanol (0.1 mg/kg) in 18 clinically normal adult beagles in a blinded randomised change-over study. Following the injection of romifidine alone the dogs became recumbent and there was an increase in a subjective score awarded to the degree of sedation. Heart rate and respiratory rate decreased and minor bradyarrhythmias were noted. The romifidine-butorphanol combination produced a significant decrease in the time to the onset of sedation and increase in the sedative effect and duration of action compared with romifidine alone. With the exception of a further decrease in heart rate and respiratory rate, there were no additional side effects following the use of the romifidine-butorphanol combination. The marked sedative effect associated with this combination would appear to be useful in the clinical situation where an increased degree of sedation is required.