Insomnia in elderly patients – various ways to manage

Introduction: Impaired duration, rhythm and depth of sleep and wakefulness called insomnia is a common problem in the group of geriatric patients. About 50% of elderly people report insomnia. Material and Methods: The paper reviews literature using the EBSCO and Google Scholar databases. Articles have been analyzed using the keywords insomnia, elderly patients, prevalence and etiology, primary care, treatment, diet, physiotherapy. The article presents various methods to manage insomnia among the elderly. Results: The main treatment for insomnia includes pharmacological and non-pharmacological interventions or a combination of both. A very important aspect is proper dietary, physiotherapy treatment and physical activity. Conclusions: Effective management of sleep disorders improves the quality of life of patients struggling with this disorder and prevents the occurrence of depression and anxiety, which often coexist with insomnia

Pharmacotherapy of depression in palliative patients

Introduction: Depression often affects people suffering from serious illnesses, including oncological and palliative patients. It reduces their quality of life and worsens their prognosis. This is why it is so important to properly treat depression in palliative patients. Material and Methods: The information provided was collected as a result of analysis of various articles and textbooks on development, diagnosis and treatment, as well as prevention of depression in terminally ill patients using Google Scholar and PubMed databases. Results: The results show that the most common drug in therapy for palliative patients with depression are the sluggish serotonin reuptake inhibitors (SSRIs). SSRIs inhibit serotonin transporter reducing serotonin reuptake. This raises the level of neurotransmitter - serotonin - in the synaptic cleft. They are well tolerated and have fewer side effects than older antidepressants (tricyclic antidepressants and monoamine oxidase inhibitors). Tricyclic antidepressants may relieve neuropathic pain and they are also beneficial for patients with insomnia. Mirtazapine in addition to antidepressant effects also causes increasing appetite, reducing nausea and sedative effect. In cancer-diagnosed patients particular attention should be paid to side effects such as nausea and vomiting that may occur in patients undergoing radiotherapy and chemotherapy using SSRIs or TCAs. SSRI therapy have a good safety profile and also interacts less frequently, while atypical antipsychotics may reduce the discomforts of taking chemotherapy. An alternative method of treating depression is the use of psychostimulants such as methylphenidate. Another way to treat depression is psychotherapy. Conclusions: There are several options for treating depression in palliative patients. It is important to pay attention to the side effects of prescribed medicines. Nevertheless, the best results are obtained by combining pharmacotherapy with psychotherapy