Psychiatric News March 15, 2002
Volume 37 Number 6
© 2002 American Psychiatric Association
p. 35
PET Scans Unnecessary?
Arthur C. Walsh, M.D.
Cranberry Township, Pa.
In regard to the article "PET Scans Can Reveal Early Alzheimer’s Signs" in the December 21 issue, I believe this will lead to expensive and unnecessary testing as a routine procedure. Most dementia patients are easily diagnosed clinically, and even the families recognize the patient as being demented before coming to the office. Furthermore, the only tests usually necessary are a brain scan to rule out tumor and blood tests for hypothyroidism and pernicious anemia. Also, there are articles now indicating that Alzheimer himself did not believe he had discovered a new type of dementia.
It is my opinion that most of the Alzheimer’s and related dementias are due to impaired brain circulation. I have treated more than 500 dementia patients over a 35-year period with anticoagulant therapy combined with psychotherapy and have found worthwhile improvement in 50 percent of the patients and dramatic reversal in 20 percent. The 50 percent not responding do require more research for a more effective treatment program.
Meanwhile, I believe every patient should have the opportunity for anticoagulant therapy and psychiatric care before being enrolled in an experimental drug program. A four-month trial will reveal patients who do not respond. The risk of warfarin sodium therapy is very small, and the benefits can be tremendous.
Some psychiatrists may prefer that another doctor handle the anticoagulant therapy, but he or she should be sure that the prothrombin time is kept in the therapeutic range. This is one of the most gratifying treatments I have seen in 50 years of medical practice.
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