A review of pharmacological and psychosocial management of AIDS dementia complex

AIDS Dementia Complex (ADC) is a common neurological complication of HIV/AIDS. ADC is characterized by cognitive, behavioral, and motor impairments including slowed thinking, decreased concentration, forgetfulness, apathy, irritability, anxiety, clumsiness, leg weakness, and altered handwriting. Symptoms progress into pronounced verbal and motor slowing, extensive thought disturbances, profound disorientation, hostility, ataxia, incontinence, and eventually a near vegetative state. Presently, no cure is available for ADC. However, treatment with the antiretroviral drug, zidovudine (AZT), has been shown to slow the progression of ADC and improve functioning. Other promising pharmacological treatments under investigation include newer antiretroviral drugs, combination use of protease inhibitors and zidovudine, calcium channel blocking agents, receptor antagonists for excitatory neurotransmitters, and antagonists of cytokines and inflammatory agents. Psychosocial interventions for managing patients in the early stages of ADC focus on preserving independence, promoting self-esteem, and assisting patients to compensate for cognitive changes. During the later stages of ADC, interventions deal with adapting patients\u27 environments to ensure safety and maintain structure, routine, and simplicity. Prompt intervention is essential to improving the quality and length of these patients\u27 lives