Adjuvant Treatment of HIV Dementia with Psychostimulants

  • Francisco Fernandez
  • Joel K. Levy


Individuals infected with the human immunodeficiency virus (HIV) manifest signs and symptoms of the disease ranging from asymptomatic infection to full-blown AIDS.1 The virus preys upon T cells, thus destroying immune function and eventually leaving the body open to overwhelming opportunistic infections or cancer. HIV is now believed to be neurotropic as well, and may attack the central nervous system (CNS) at any point during the infection.2 The results are indeed protean, and this infection has been compared to other neurodegenerative pathogens, including syphilis.3


Human Immunodeficiency Virus Human Immunodeficiency Virus Infection Human Immunodeficiency Virus Patient Human Immunodeficiency Virus Disease Global Deterioration Scale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fauci AS, Masur H, Gelmann EP, et al: The acquired immunodeficiency syndrome: An update. Ann Intern Med 102: 800–813, 1985.PubMedCrossRefGoogle Scholar
  2. 2.
    Price RW, Brew B, Sidtis J, et al: The brain in AIDS: Central nervous system HIV-1 infection and AIDS dementia complex. Science 239: 586–592, 1988.PubMedCrossRefGoogle Scholar
  3. 3.
    Felgenhauer K: Another venereal disease with frequent nervous system involvement: neuro-AIDS. J Neurol 234: 65–66, 1987.PubMedCrossRefGoogle Scholar
  4. 4.
    Fernandez F: Psychiatric complications in HIV–related illnesses, in American Psychiatric Association’s AIDS Primer. Washington, DC, American Psychiatric Association, 1989, pp. 5–1–5–7.Google Scholar
  5. 5.
    Gyorkey F, Melnick JL, Gyorkey P: Human immunodeficiency virus in brain biopsies of patients with AIDS and progressive encephalopathy. J Infect Dis 155:870–876, 1987.Google Scholar
  6. 6.
    Vazeux R, Brousse N, Jarry A, et al: AIDS subacute encephalitis: Identification of HIV-infected cells. Am J Pathol 126: 403–410, 1987.PubMedGoogle Scholar
  7. 7.
    Wiley CA, Schrier RD, Nelson JA, et al: Cellular localization of human immunodeficiency virus infection within the brains of acquired immunodeficiency syndrome patients. Proc Natl Acad Sci USA 83: 7089–7093, 1986.PubMedCrossRefGoogle Scholar
  8. 8.
    Funke I, Hahn A, Rieber EP, et al: The cellular receptor (CD4) of the human immunodeficiency virus is expressed on neurons and glial cells in the human brain. J Exp Med 165: 1230–1235, 1987.PubMedCrossRefGoogle Scholar
  9. 9.
    Grant I, Atkinson H, Hesselink JR, et al: Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections: Studies with neuropsychological testing and magnetic resonance imaging. Ann Intern Med 107: 828–836, 1987.PubMedCrossRefGoogle Scholar
  10. 10.
    Navia BA, Price RW: The acquired immunodeficiency syndrome dementia complex as the presenting or sole manifestation of human immunodeficiency virus infection. Arch Neurol 44: 65–69, 1987.PubMedCrossRefGoogle Scholar
  11. 11.
    Klerman GL: Psychotropic hedonism versus pharmacological Calvinism. Hastings Center Rep 2(4):l-3, 1971.Google Scholar
  12. 12.
    Tesar GE: The role of stimulants in general medicine. Drug Ther July:l86–196, 1982.Google Scholar
  13. 13.
    Woods SW, Tesar GE, Murray GB, et al: Psychostimulant treatment for depressive disorders secondary to medical illness. J Clin Psychiatry 47: 12–15, 1986.PubMedGoogle Scholar
  14. 14.
    Jenicke MA: Assessment and treatment of affective illness in the elderly. J Geriatr Psychiatry Neurol 1 (2): 91–107, 1988.Google Scholar
  15. 15.
    Fernandez F, Adams F, Holmes VF, et al: Methylphenidate for depressive disorders in cancer patients. Psychosomatics 28: 455–461, 1987.PubMedCrossRefGoogle Scholar
  16. 16.
    Fernandez F, Adams F, Levy JK, et al: Cognitive impairment due to AIDS-related complex and its response to psychostimulants. Psychosomatics 29: 38–46, 1988.PubMedCrossRefGoogle Scholar
  17. 17.
    McArthur JD: Neurologic manifestations of AIDS. Medicine (Baltimore) 66: 407–437, 1987.Google Scholar
  18. 18.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3, revised. Washington, DC, American Psychiatric Press, 1987.Google Scholar
  19. 19.
    Folstein MF, Folstein SE, McHugh PR: “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189–198, 1975.PubMedCrossRefGoogle Scholar
  20. 20.
    Fernandez F. Levy JK, Salmeron G: The incidence of dementia and other organic mental disorders (OMDs) associated with human immunodeficiency virus (HIV) infection. Current Concepts in Psycho-Oncology and AIDS. Syllabus of the Postgraduate Course. New York, Memorial Sloan-Kettering Cancer Center, September 17–19, 1987, p. 399.Google Scholar
  21. 21.
    Reisberg B, Ferris SH, de Leon MI, et al: The global deterioration scale (GDS): An instrument for the assessment of primary degenerative dementia (PDD). Am J Psychiatry 139: 1136–1139, 1982.PubMedGoogle Scholar
  22. 22.
    Janssen RS, Saykin AL, Kaplan JE, et al: Neurological complications of human immunodeficiency virus infection in patients with lymphadenopathy syndrome. Ann Neurol 23: 49–55, 1988.PubMedCrossRefGoogle Scholar
  23. 23.
    Navia BA, Cho E-S, Petito CK, et al: The AIDS dementia complex. II. Neuropathology. Ann Neurol 19: 525–535, 1986.PubMedCrossRefGoogle Scholar
  24. 24.
    Levy JK, Fernandez F, Pirozzolo FJ: Patterns of cognitive impairment in HIV infection: A preliminary report. J Clin Exp Neuropsychol 10: 77, 1988.Google Scholar
  25. 25.
    Whitehouse P: The concept of subcortical and cortical dementia: Another look. Ann Neurol 19: 1–7, 1986.PubMedCrossRefGoogle Scholar
  26. 26.
    Lezak MD: Neuropsychological Assessment, ed 2. New York, Oxford University Press, 1983.Google Scholar
  27. 27.
    Levy JK, Fernandez F: Neuropsychiatrie care for critically ill AIDS patients. J Crit Illness 4: 33–42, 1989.Google Scholar
  28. 28.
    Maccario M, Scharre DW: HIV and acute onset of psychosis. Lancet 2: 342, 1987.PubMedCrossRefGoogle Scholar
  29. 29.
    Nath A, Jankovic J, Pettigrew LC: Movement disorders and AIDS. Neurology (NY) 37: 37–41, 1987.Google Scholar
  30. 30.
    Pumarola-Sune, T, Navia BA, Cordon-Cardo C, et al: HIV antigen in the brains of patients with AIDS dementia complex. Ann Neurol 21: 490–496, 1987.PubMedCrossRefGoogle Scholar
  31. 31.
    Hill JM, Farrar WL, Pert CB: Localization of the T4 antigen/AIDS virus receptor in monkey and rat brains: Prominence in cortical regions. Psychopharm Bull 22: 689–694, 1986.Google Scholar
  32. 32.
    Fernandez F, Levy JK, Galizzi H: Response to HIV-related depression to psychostimulants: Case reports. Hosp Comm Psychiatry 39: 628–631, 1988.Google Scholar
  33. 33.
    Levin HS: Learning and memory, in Hannay HJ (ed): Experimental Techniques in Human Neuropsychology. New York, Oxford University Press, 1986, pp. 309–362.Google Scholar
  34. 34.
    Benton AL: Revised Visual Retention Test, ed 4. New York, The Psychological Corporation, 1974.Google Scholar
  35. 35.
    Benton AL, deS Hamsher K: Multilingual Aphasia Examination. Iowa City, The University of Iowa, 1983.Google Scholar
  36. 36.
    Pfeiffer E: A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 23: 433, 1975.PubMedGoogle Scholar
  37. 37.
    Benton AL, deS Hamsher K, Varney NR, Spreen O: Contributions to Neuropsychological Assessment: A clinical Manual. New York, Oxford University Press, 1983.Google Scholar
  38. 38.
    Lacks P: Bender Gestalt Screening for Brain Dysfunction. New York, John Wiley-Interscience, 1984.Google Scholar
  39. 39.
    Raven JC, Court JH, Raven J: Manual for Raven’s Progressive Matrices and Vocabulary Scales: Section 3: Standard Progressive Matrices. London, H.K. Lewis and Co., Ltd., 1983.Google Scholar
  40. 40.
    Wechsler D: WAIS-R Manual. New York, The Psychological Corporation, 1981.Google Scholar
  41. 41.
    Golden CJ, Osmon DC, Moses JA Jr, et al: Interpretation of the Halstead-Reitan Neuropsychological Test Battery: A Case book Approach. New York: Grune and Stratton, 1981.Google Scholar
  42. 42.
    Pirozzolo FJ, Christensen KJ, Ogle KM, et al: Simple and choice reaction time in dementia: clinical implications. Neurobiol Aging 2: 113, 1981.PubMedCrossRefGoogle Scholar
  43. 43.
    Zachary RA: Shipley Institute of Living Scale Revised Manual. Los Angeles, Western Psychological Services, 1987.Google Scholar
  44. 44.
    Golden CJ: Stroop Color and Word Test: A Manual for Clinical and Experimental Uses. Chicago, Stoelting Company, 1978.Google Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Francisco Fernandez
    • 1
    • 2
  • Joel K. Levy
    • 2
  1. 1.St. Luke’s Episcopal HospitalHoustonUSA
  2. 2.Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonUSA

Personalised recommendations