171 The important contribution of this work to practice in dental hospitals was recognized in an editorial in the same issue of the British Dental Journal, which endorsed the recommendation that patients should receive written instructions on leaving the units due to the persistent, amnesia measured by the CDR tests following midazolam. Temazepam is also used as a premedication in day case surgery. In one trial, patients

were assessed prior to and several times postsurgery; temazepam or matching placebos being administered preoperatively.172 The effects of anesthesia were easily detected by the cognitive tasks, as were the additional but, temporary impairments produced by temazepam. Reversing deficits in Inhibitors,research,lifescience,medical various patient populations In chronic fatigue syndrome, the deficits in attention were shown Inhibitors,research,lifescience,medical to be temporarily reversed by the administration of oxygen.173 In elderly depressed patients,

those Lapatinib treated with placebo showed an increase in cognitive impairment on various tasks over a 50-day period.174 Those who were treated with nortriptyline showed improvements in Hamilton Depression Rating Scale (HAM-D) scores and also showed a smaller decline in performance over the 50-day period. The group of patients treated with moclobemide, however, showed no decline but actually a significant Inhibitors,research,lifescience,medical enhancement in performance over the study This study suggests that the cognitive impairment associated with depression will worsen if it is not treated. Even a tricyclic compound like nortriptyline, which will impair function under normal conditions, will show some degree of improvement as the symptoms of depression are treated and the cognitive impairment remits. However, compounds such as moclobemide, Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical which are free from unwanted effects, and possible cognitive enhancers will improve function in such patients by treating depression and having no liability to compromise efficiency. In elderly hypertensive patients who were on long-term treatment

using the β-blocker atenolol, a trial was performed by switching half of the patients to the ACE inhibitor cilazapril.175 Cognitive function was assessed using the CDR system over a 20-week period. Significant improvement and in choice reaction time and a pattern of enhancement in many other assessments was seen in the patients switched to cilazapril. This trial suggests that β-blocker withdrawal should be considered for anyelderly patient showing signs of cognitive dysfunction. The effects of herbal medicines are becoming increasingly studied as the push towards evidence-based medicine spreads into this field. Ginkgo has been shown to improve function in elderly people with mild cognitive impairment in a 3-month, placebo-controlled, double-blind trial.176 Such effects have also been seen in patients with more severe cognitive decline.