Materiały źródłowe

• #1 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Treatment of CBS can vary depending on the severity of symptoms. In mild symptoms, reassurance may be all that is needed. However, in more severe symptoms, treatment includes behavioral techniques and medications to suppress hallucinations. Studied techniques include blinking during hallucination or rapid eye movement from one object to another away from the perceived hallucination field of vision. The mainstay of management is physician awareness and compassion. […] Medications are often reserved for severe diseases, including those with disturbing or continuous hallucinations. Antipsychotics have been found to have mixed efficacy; however, atypical antipsychotics such as low doses of quetiapine or olanzapine are preferred due to safer side effect profiles, especially in the elderly CBS tends to affect. Other medications with good efficacy and minimal side effects include cholinesterase inhibitors such as donepezil. Beneficial medications anecdotally include antiepileptics such as valproate, carbamazepine, gabapentin, and clonazepam. Lastly, some promising medications that are effective in small case series include antidepressants such as venlafaxine and escitalopram, as well as prokinetic agents like cisapride.

• #2 Charles Bonnet Syndrome: Complete Remission of Visual Hallucinations with Trazodone

  https://www.jneuropsychiatry.org/peer-review/charles-bonnet-syndrome-complete-remission-of-visual-hallucinations-with-trazodone-12999.html

  Charles Bonnet syndrome (CBS) is a neuro-ophthalmic condition that affects elderly people with visual impairment related to ophthalmological pathologies. […] Treatment should address to its ophthalmologic etiology but pharmacological management of visual hallucinations may be done as well. […] We report a case of an 86-year-old woman with a characteristic clinical picture of CBS that had complete remission of her visual hallucinations with trazodone treatment. […] Its prescription should be considered as one of the first steps in the management of Charles Bonnet syndrome. […] The first step in the management of CBS is to treat the underlying ophthalmologic condition to enhance visual input thus inhibiting hallucinations. If this approach fails, pharmacological therapy may be considered. […] A single study has reported three cases of CBS patients whose hallucinations improved with trazodone. […] Our report adds to that of Hsu et al. and points trazodone to be considered as a first-line treatment for CBS, due to its good tolerability and few interactions with other drugs.

• #3 Eyes – Charles Bonnet syndrome | Better Health ChannelExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal Link

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-charles-bonnet-syndrome

  In most cases, Charles Bonnet syndrome resolves itself after about 12 to 18 months without treatment. […] Sometimes the hallucinations don’t go away, but there is no medical cure. Depending on the severity of the condition, treatment may include: Medical advice – talking it over with a doctor or counsellor can be helpful. Vision therapy – low-vision rehabilitation may help to ease symptoms. Moving your eyes – some people report that the hallucinations dissipate if they move their gaze from side to side or up and down. Changing the variables – to ‘turn off’ the hallucination, you could try altering the environment or setting that you are in. For example: if it’s dark, turn on the light, or if you’re standing up, sit down. If your eyes are open, shut them, or if you’re in one room, go to another room.

• #4 Charles Bonnet Syndrome – Patients – The American Society of Retina Specialists

  https://www.asrs.org/patients/retinal-diseases/38/charles-bonnet-syndrome

  Doctors have tried a number of medications, but there is no definitive treatment for visual hallucinations. […] Many patients improve over time; however, the hallucinations can go on for months or years. Blinking or closing their eyes helps some people with CBS. Others find it beneficial to improve their lighting or have more social interactions.

• #5 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Various techniques such as hypnosis, relaxation training, distraction, cognitive remodeling, and psychological therapy for the phantom phenomenon have been advocated to minimize visual hallucinations’ unpleasant and troublesome effects. […] CBS patients may experience anxiety and are usually unaware of the condition. Many patients may show disappointment and unsympathetic reactions to meeting the healthcare professional regarding their hallucinations. Reassurance is necessary as most patients are comforted when told that it’s not a psychiatric phenomenon but is named CBS. The patients are also reassured that vision loss is benign and not harmful and there is no underlying mental illness. Patients with intact cognition need no further intervention, but patients having dementia may be difficult to reassure because of a lack of insight and vision loss of distressing nature. Reassurance and counseling are the mainstays of treatment.

• #6 Charles Bonnet Syndrome | Macular Disease Foundation Australia

  https://www.mdfoundation.com.au/about-macular-disease/other-conditions/charles-bonnet-syndrome/

  Theres no proven treatment or cure for CBS. […] If you are experiencing CBS, understanding the syndrome, knowing it is not a mental health issue, and coming to terms with your visions appears to be the best course of action. […] There are a few activities that may help to make the phantom images stop. Interrupting your vision for a short time by closing your eyes or blinking, or moving your eyes from left to right and up and down may help. […] For most people, the best way to manage the condition is just knowing CBS is a result of their vision loss and not other health problems. […] If you have serious, disturbing visions, there are some medications that might be helpful. However, they dont work for everyone. You should discuss this with your ophthalmologist.

• #7 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  This beneficial impact on hallucination may be the best treatment, although visual deficit correction may not always be possible, especially in elderly patients. The spectacle and visual aid prescription are necessary for optical correction, and cataract surgery may be necessary for visual correction.

• #8 What is Charles Bonnet syndrome, the eye condition that causes hallucinations?

  https://theconversation.com/what-is-charles-bonnet-syndrome-the-eye-condition-that-causes-hallucinations-122322

  For patients with debilitating symptoms, doctors may trial medications such as antidepressants, antipsychotics and antiepileptic drugs, though their efficacy is variable and may be outweighed by side effects. […] Hallucinations may disappear if the cause of vision loss can be corrected (for example, if severe cataracts were causing blindness and the patient has a cataracts operation). […] Unfortunately though, generally the causes of vision loss that lead to Charles Bonnet syndrome can’t be treated.

• #9 Charles Bonnet Syndrome – EyeWiki

  https://eyewiki.org/Charles_Bonnet_Syndrome

  There is no known treatment for this condition. For those with CBS due to correctable eye diseases, the hallucinations may spontaneously remit or improve with the treatment of the underlying cause of visual loss. For example, patients with CBS caused by macular degeneration reported resolution of hallucinations with photodynamic therapy and patients with cataracts had resolution of CBS with CE/PCIOL. […] Management primarily consists of providing empathy and reassurance. Patients are usually stressed due to concern of psychiatric illness rather than the hallucinations themselves, and reassurance has been shown to greatly increase patient comfort with CBS. […] Pharmacologic therapy may be considered in cases of disturbing hallucinations causing significant distress to the patient. Some medications have been tried, including antipsychotics, antiepileptics, cholinesterase inhibitors, SSRIs, and levetiracetam, but most of this data comes from case reports. […] Due to the lack of strong evidence in regards to pharmacologic treatment, non-pharmacologic methods are preferred, including eye closure, repeated blinking, bright lighting, and reducing patient isolation.

• #10 Charles Bonnet syndrome improves when treatment is effective in age-related macular degeneration | British Journal of Ophthalmology

  https://bjo.bmj.com/content/95/2/291.2

  The Charles Bonnet syndrome (CBS) is characterised by vivid, complex and recurrent visual hallucinations occurring in psychologically normal people, and it is often associated with vision impairment. No effective treatment of CBS has been identified. […] We investigated whether intravitreal ranibizumab therapy for neovascular age-related macular degeneration (AMD) affects symptoms of CBS.

• #11 Charles Bonnet syndrome (CBS) – Macular Society

  https://www.macularsociety.org/macular-disease/macular-conditions/charles-bonnet-syndrome/

  Can you stop the hallucinations caused by CBS? […] The Macular Society has sponsored research by Dr Dominic ffytche at King’s College London to look into ways of stopping Charles Bonnet hallucinations when they occur. […] Dr ffytche recommends using eye movements to lessen the impact and length of hallucinations. […] Other treatments […] Stopping hallucinations when they occur works for some people but others need more help. […] There are treatments available now and being developed. […] Some medications can help people with very distressing hallucinations. […] Developing new treatments for hallucinations is important. […] The Macular Society has sponsored research led by Professor John-Paul Taylor at Newcastle University to investigate whether using a mild electric current on the scalp at the back of the head can stop visual hallucinations caused by Charles Bonnet syndrome.

• #12 Charles Bonnet Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/eye-care/charles-bonnet-syndrome

  Charles Bonnet syndrome treatment […] There is no cure for CBS. Doing the following can all help to reduce the frequency of hallucinations: […] Increasing lighting levels in the evening. […] Being active both physically and mentally. […] Spending more time in the company of others. […] Eye movements have been shown to lessen the impact and length of the hallucinations – see Macular Society in Further Reading (below). […] Anxiety treatments such as antidepressants are sometimes offered to those who find their symptoms upsetting. […] For most patients, understanding the cause of the symptoms – and realising that they are not becoming mentally ill – is all that is needed. […] Suggestions to try when having a CBS hallucination […] Eye movement exercise: […] Imagine two points about 3 feet apart on a wall in front of you.

• #13 Testing therapies to reduce severity of visual hallucinations – Macular Society

  https://www.macularsociety.org/research/explore/projects/research-grants/testing-therapies-reduce-severity-visual-hallucinations/

  Many people with vision loss experience Charles Bonnet Syndrome (CBS), which leads to visual hallucinations. […] This trial aims to test current suggested techniques for reducing the severity of hallucinations. […] Several techniques are currently promoted which claim to reduce the severity and impact of these hallucinations, but no studies have been done to prove if they work. […] This study looks to evaluate the efficacy of two techniques: eye movement therapy and distraction/interruption therapy. […] Eye movement therapy involves making voluntary eye movements (e.g. quickly moving your eyes side to side or up and down) to try and disrupt the signals from the brain causing the hallucination. […] Distraction/interruption therapy involves changing the environment to interrupt the hallucination. This can be done by changing lighting (turning lights off or on), moving into a different room, or changing your posture or task. […] This trial aims to help understand whether the current recommendations for stopping CBS hallucinations do help. Having proof of whether these therapies can help stop hallucinations would ensure that these techniques are better promoted to those who might need them.

• #14 Charles Bonnet Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/eye-care/charles-bonnet-syndrome

  Stand about 4.5 to 5 feet away and look from one point to the other once every second or faster for 15 to 30 seconds. […] Don’t move your head and keep your eyes open when looking left and right. […] Have a break of a few seconds. If the hallucination is still there, try repeating the exercise. […] If this exercise doesn’t work after 4 or 5 attempts it probably won’t work this time. […] It’s worth trying again with a different type of hallucination. […] Other things to try: […] Shut your eyes or look in a different direction. […] Turn on the lights (or brighten them if dimmed), or move somewhere darker (if you are already in a light room). […] Move away and do something different. This can make the hallucinations stop, but they often continue. […] […] […] For most patients, understanding the cause of the symptoms – and realising that they are not becoming mentally ill – is all that is needed.

• #15 Managing CBS | Esme’s Umbrella

  https://www.charlesbonnetsyndrome.uk/managing-cbs

  Medications that are based on evidence from clinical trials or published case reports. Anti-convulsant (like Gabapentin) […] Cholinesterase inhibitor (like Donepezil) […] SSRI (like Citalopram) […] Anti-psychotic (like Risperidone) not suitable for older patients […] Chinese traditional medicine (like Yi-Gan-San). […] People with CBS have reported that Prochlorperazine helped their symptoms […] Omega 3 has helped reduce hallucinations in people with CBS […] CBD oil has helped people with CBS alleviate their symptoms […] Ginger has helped people who suffer with CBS […] Guided meditation can be good coping strategy […] Yoga can help alleviate symptoms of CBS […] Counselling is helpful for people with CBS […] Group Therapy can be a supportive environment to deal with CBS.

• #16 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Treatment of CBS can vary depending on the severity of symptoms. In mild symptoms, reassurance may be all that is needed. However, in more severe symptoms, treatment includes behavioral techniques and medications to suppress hallucinations. Studied techniques include blinking during hallucination or rapid eye movement from one object to another away from the perceived hallucination field of vision. The mainstay of management is physician awareness and compassion. […] Medications are often reserved for severe diseases, including those with disturbing or continuous hallucinations. Antipsychotics have been found to have mixed efficacy; however, atypical antipsychotics such as low doses of quetiapine or olanzapine are preferred due to safer side effect profiles, especially in the elderly CBS tends to affect. Other medications with good efficacy and minimal side effects include cholinesterase inhibitors such as donepezil. Beneficial medications anecdotally include antiepileptics such as valproate, carbamazepine, gabapentin, and clonazepam. Lastly, some promising medications that are effective in small case series include antidepressants such as venlafaxine and escitalopram, as well as prokinetic agents like cisapride.

• #17 A low dose of risperidone resolved Charles Bonnet syndrome after an un | NDT

  https://www.dovepress.com/a-low-dose-of-risperidone-resolved-charles-bonnet-syndrome-after-an-un-peer-reviewed-fulltext-article-NDT

  This case report describes a successful response to risperidone in an 87-year-old woman with CBS after an unsuccessful trial of quetiapine. […] The patient was initially treated with quetiapine 25 mg/day, which was later increased to 50 mg/day. After 1 month, the hallucinations were still present, and the patient was distressed. Hence, the treatment was changed to risperidone, 0.5 mg/day. After 3 days, the patient had cessation of the visual hallucinations lasting until her next visit, 6 weeks later. […] The patients visual hallucinations did not improve with a trial of quetiapine, but responded to a low dose of risperidone. A small number of reports show improvement in visual hallucinations with risperidone and olanzapine. […] Although there has been no standard treatment so far, anecdotal evidence seemed to favor antipsychotics and SSRIs as possible treatment options for the disturbing hallucinations associated with CBS. […] In more severe and disturbing cases, pharmacological treatment is required. Case reports or case series on the topic or even small trials, possibly with a longer follow-up duration, are still needed to define best treatment.

• #18 Challenges of diagnosing and treating Charles Bonnet syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6105053/

  Consider Charles Bonnet syndrome in patients with optical hallucinations after occipital stroke. […] Treatment of these vivid hallucinations is challenging and there is no standard treatment. Here, we present a stroke patient with CBS successfully treated with melperone. […] We initiated therapy with aripiprazole (5 mg daily) to treat the visual hallucinations. However, the 2-month intake of aripiprazole did not significantly reduce the frequency or the intensity of these hallucinations. Therefore, we administered melperone (25 mg daily), resulting in a disappearance of the visual hallucinations 2 weeks after initiation of treatment. […] A mainstay of treatment is the reassurance of patients that these visual hallucinations are inherently benign and not a sign of a psychiatric disorder. A large number of anticonvulsant and antipsychotic drugs (e.g., carbamazepine, valproate, olanzapine, mirtazapine) have been reported to relieve visual hallucinations associated with CBS.

• #19 Challenges of diagnosing and treating Charles Bonnet syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6105053/

  In the present case, melperone resulted in an improvement of visual hallucinations, which is in line with an observation of a previous case series. […] By blocking 5HT2AR, melperone might attenuate the excitability of the visual network in the absence of visual inputs and thus counteract the deafferentation, which might lead to a cessation of visual hallucinations. This assumption might be further corroborated by the fact that aripiprazole, a partial agonist at the 5HT2AR, had no effect on the hallucinations. However, the effectiveness of melperone on hallucinations has to be proved further in a larger cohort of patients with CBS.

• #20

  https://link.springer.com/article/10.1007/s10072-005-0455-0

  Charles Bonnet syndrome (CBS) is characterised by the triad of complex visual hallucinations, ocular pathology causing visual deterioration and preserved cognitive status. […] Therapy with olanzapine (OLZ) 5 mg/day led to a progressive clearance of visual hallucinations in seven days and was gradually reduced and withdrawn. […] To date, no established treatment for CBS is stated and in some patients the hallucinations fade spontaneously; in our case an antipsychotic therapy with OLZ was effective while generally anticonvulsant drugs with different mechanism of action such as carbamazepine, valproate and gabapentin are proposed.

• #21 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  Elderly patients are particularly prone to sedation, falls, hypotension, urinary retention, extra pyramidal side effects, metabolic syndrome and cardiac side effects from psychotropics. Hence psychotropics must be used judiciously, at the lowest possible doses, with the awareness of possible side effects and drug interactions and careful monitoring. Atypical antipsychotics have a favourable side effect profile compared to the typicals and are relatively safer in older adults.

• #22

  https://link.springer.com/article/10.1007/s11940-019-0582-1

  Ukai S, Yamamoto M, Tanaka M, Takeda M. Treatment of typical Charles bonnet syndrome with donepezil. Int Clin Psychopharmacol. 2004;19(6):3557. […] Bergman Y, Barak Y. Escitalopram for antipsychotic nonresponsive visual hallucinosis: eight patients suffering from Charles Bonnet syndrome. Int Psychogeriatr. 2013;25(9):14336. […] Hori H, Terao T, Shiraishi Y, Nakamura J. Treatment of Charles bonnet syndrome with valproate. Int Clin Psychopharmacol. 2000;15(2):1179. […] Miyaoka T, Furuya M, Kristian L, Wake R, Kawakami K, Nagahama M, et al. Yi-gan san for treatment of charles bonnet syndrome (visual hallucination due to vision loss): an open-label study. Clin Neuropharmacol. 2011;34(1):247. […] Alamri SH. A low dose of risperidone resolved Charles Bonnet syndrome after an unsuccessful trial of quetiapine: a case report. Neuropsychiatr Dis Treat. 2018;14:80911.

• #23

  https://link.springer.com/article/10.1007/s11940-019-0582-1

  Boren RA, Boren CB. Charles Bonnet syndrome treated with pimavanserin. J Neuro-Ophthalmol Off J North Am Neuro-Ophthalmol Soc. 2019:1. […] Barnes JJ. The Charles Bonnet syndrome: symptomatic relief with atypical neuroleptics: a case series. Int J Psychiatry Clin Pract. 2001;5(2):1414. […] Hanoglu L, Yildiz S, Polat B, Demirci S, Tavli AM, Yilmaz N, et al. Therapeutic effects of rivastigmine and alfa-lipoic acid combination in the Charles Bonnet syndrome: electroencephalography correlates. Curr Clin Pharmacol. 2016;11(4):2703. […] Paulig M, Mentrup H. Charles Bonnets syndrome: complete remission of complex visual hallucinations treated by gabapentin. J Neurol Neurosurg Psychiatry. 2001;70(6):8134. […] Grter T, Ayzenberg I, Gold R, Brnke C. Charles Bonnet syndrome successfully treated with levetiracetam. J Neurol. 2016;263(9):18725.

• #24 Challenges of diagnosing and treating Charles Bonnet syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6105053/

  Consider Charles Bonnet syndrome in patients with optical hallucinations after occipital stroke. […] Treatment of these vivid hallucinations is challenging and there is no standard treatment. Here, we present a stroke patient with CBS successfully treated with melperone. […] We initiated therapy with aripiprazole (5 mg daily) to treat the visual hallucinations. However, the 2-month intake of aripiprazole did not significantly reduce the frequency or the intensity of these hallucinations. Therefore, we administered melperone (25 mg daily), resulting in a disappearance of the visual hallucinations 2 weeks after initiation of treatment. […] A mainstay of treatment is the reassurance of patients that these visual hallucinations are inherently benign and not a sign of a psychiatric disorder. A large number of anticonvulsant and antipsychotic drugs (e.g., carbamazepine, valproate, olanzapine, mirtazapine) have been reported to relieve visual hallucinations associated with CBS.

• #25 Charles Bonnet Syndrome: Complete Remission of Visual Hallucinations with Trazodone

  https://www.jneuropsychiatry.org/peer-review/charles-bonnet-syndrome-complete-remission-of-visual-hallucinations-with-trazodone-12999.html

  Charles Bonnet syndrome (CBS) is a neuro-ophthalmic condition that affects elderly people with visual impairment related to ophthalmological pathologies. […] Treatment should address to its ophthalmologic etiology but pharmacological management of visual hallucinations may be done as well. […] We report a case of an 86-year-old woman with a characteristic clinical picture of CBS that had complete remission of her visual hallucinations with trazodone treatment. […] Its prescription should be considered as one of the first steps in the management of Charles Bonnet syndrome. […] The first step in the management of CBS is to treat the underlying ophthalmologic condition to enhance visual input thus inhibiting hallucinations. If this approach fails, pharmacological therapy may be considered. […] A single study has reported three cases of CBS patients whose hallucinations improved with trazodone. […] Our report adds to that of Hsu et al. and points trazodone to be considered as a first-line treatment for CBS, due to its good tolerability and few interactions with other drugs.

• #26 Charles bonnet syndrome (CBS): Successful treatment of visual hallucinations due to vision loss with trazodone in three cases | European Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/european-psychiatry/article/charles-bonnet-syndrome-cbs-successful-treatment-of-visual-hallucinations-due-to-vision-loss-with-trazodone-in-three-cases/E364D971923762484F3450BE0E6F422D

  CBS becomes more prevalent as the population ages and the number of patients with low vision increases. […] They responded well to treatment with trazodone. […] This is the first report describing the effectiveness of trazodone in treating typical CBS patients. It indicates that trazodone is a safer option for the treatment of CBS, especially in the elderly, diabetic population. […] In addition to having fewer interactions with comedications, trazodone has fewer adverse effects and relative lower body weight gain risk compared to anticonvulsants and neuroleptics.

• #27

  https://link.springer.com/article/10.1007/s11940-019-0582-1

  Sawant NS, Bokdawala RA. Pregabalin in the treatment of Charles Bonnet syndrome. JPMA J Pak Med Assoc. 2013;63(4):5301. […] Siddiqui Z, Ramaswmay S, Petty F. Mirtazapine for Charles Bonnet syndrome. Can J Psychiatr Rev Can Psychiatr. 2004;49(11):7878. […] Lang UE, Stogowski D, Schulze D, Domula M, Schmidt E, Gallinat J, et al. Charles bonnet syndrome: successful treatment of visual hallucinations due to vision loss with selective serotonin reuptake inhibitors. J Psychopharmacol Oxf Engl. 2007;21(5):5535.

• #28 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Treatment of CBS can vary depending on the severity of symptoms. In mild symptoms, reassurance may be all that is needed. However, in more severe symptoms, treatment includes behavioral techniques and medications to suppress hallucinations. Studied techniques include blinking during hallucination or rapid eye movement from one object to another away from the perceived hallucination field of vision. The mainstay of management is physician awareness and compassion. […] Medications are often reserved for severe diseases, including those with disturbing or continuous hallucinations. Antipsychotics have been found to have mixed efficacy; however, atypical antipsychotics such as low doses of quetiapine or olanzapine are preferred due to safer side effect profiles, especially in the elderly CBS tends to affect. Other medications with good efficacy and minimal side effects include cholinesterase inhibitors such as donepezil. Beneficial medications anecdotally include antiepileptics such as valproate, carbamazepine, gabapentin, and clonazepam. Lastly, some promising medications that are effective in small case series include antidepressants such as venlafaxine and escitalopram, as well as prokinetic agents like cisapride.

• #29 Charles Bonnet Syndrome: Complete Remission of Visual Hallucinations with Trazodone

  https://www.jneuropsychiatry.org/peer-review/charles-bonnet-syndrome-complete-remission-of-visual-hallucinations-with-trazodone-12999.html

  Charles Bonnet syndrome (CBS) is a neuro-ophthalmic condition that affects elderly people with visual impairment related to ophthalmological pathologies. […] Treatment should address to its ophthalmologic etiology but pharmacological management of visual hallucinations may be done as well. […] We report a case of an 86-year-old woman with a characteristic clinical picture of CBS that had complete remission of her visual hallucinations with trazodone treatment. […] Its prescription should be considered as one of the first steps in the management of Charles Bonnet syndrome. […] The first step in the management of CBS is to treat the underlying ophthalmologic condition to enhance visual input thus inhibiting hallucinations. If this approach fails, pharmacological therapy may be considered. […] A single study has reported three cases of CBS patients whose hallucinations improved with trazodone. […] Our report adds to that of Hsu et al. and points trazodone to be considered as a first-line treatment for CBS, due to its good tolerability and few interactions with other drugs.

• #30 Charles bonnet syndrome (CBS): Successful treatment of visual hallucinations due to vision loss with trazodone in three cases | European Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/european-psychiatry/article/charles-bonnet-syndrome-cbs-successful-treatment-of-visual-hallucinations-due-to-vision-loss-with-trazodone-in-three-cases/E364D971923762484F3450BE0E6F422D

  CBS becomes more prevalent as the population ages and the number of patients with low vision increases. […] They responded well to treatment with trazodone. […] This is the first report describing the effectiveness of trazodone in treating typical CBS patients. It indicates that trazodone is a safer option for the treatment of CBS, especially in the elderly, diabetic population. […] In addition to having fewer interactions with comedications, trazodone has fewer adverse effects and relative lower body weight gain risk compared to anticonvulsants and neuroleptics.

• #31 Charles Bonnet Syndrome Foundation (Australia) – Treatments

  https://www.charlesbonnetsyndrome.org/index.php/cbs/treatments

  Challenging standard lifestyle habits can be beneficial. […] Opportunities to stimulate the senses is recommended. […] Social isolation has been mentioned as a risk factor for CBS. […] Consider (re-) incorporating healthy behaviours or activities into your daily life that can induce a sense of calm or relaxation. […] In instances where none of the above is found to be of assistance, pharmacological treatment could be explored. […] There have been numerous instances of total relief from CBS as a result of prescribed medication. […] It also needs to be noted that current medications used to treat CBS include anticonvulsant and antipsychotic drugs. […] Presently, there is no pharmaceutical drug that has been found to be effective in most, let alone all, cases. […] A more recent mode of treatment is known as repetitive transcranial magnetic stimulation (rTMS). […] There is preliminary evidence suggesting that the application of a low frequency (1 Hz) to this area can reduce brain activity. This 'dampening’ of brain activity can lead to a reduction in, or resolution of, CBS imagery.

• #32 Charles Bonnet Syndrome: what is it and what help is out there? | Glaucoma UK

  https://glaucoma.uk/blog-category-blog/charles-bonnet-syndrome-what-is-it-and-what-help-is-out-there/

  Dr Kat da Silva Morgan – an Esme’s Research Fellow – led a study at Newcastle University which showed that the occurrence of CBS hallucinations can be significantly reduced by the use of a non-invasive electrical brain stimulation technique. Investment is needed now to optimise the treatment and allow it to be adopted by the NHS and used by people at home. […] Now, I am urging the NHS to create a pathway for diagnosis and treatment – with multi-disciplinary clinics so that CBS can be diagnosed correctly and swiftly.

• #33 Charles Bonnet Syndrome: Symptoms, Causes, and TreatmentHealthline

  https://www.healthline.com/health/charles-bonnet-syndrome

  There’s no cure for CBS, but several things may help to make the condition more manageable. These include: […] In some cases, medications used to treat neurological conditions, such as epilepsy or Parkinson’s disease, may help. However, these medications may have serious side effects. […] Some people also find relief through repetitive transcranial magnetic stimulation. This is a noninvasive process that involves using magnets to stimulate different parts of the brain. It’s often used to treat anxiety and depression.

• #34 Charles Bonnet syndrome (CBS) – Macular Society

  https://www.macularsociety.org/macular-disease/macular-conditions/charles-bonnet-syndrome/

  Preliminary findings suggest it is helpful in reducing the number of hallucinations experienced and there are few, if any, side effects but further research is needed to confirm this. […] What support is there for people with CBS? […] The Macular Society runs a CBS support group via our counselling service. […] Our helpline can give you advice and information on CBS. […] If you feel you or your family need more tailored support, our counselling service is able to give you a call to discuss one-to-one telephone or group sessions. […] Would you like to take part in a study designed to evaluate simple therapies for CBS?

• #35 Managing CBS | Esme’s Umbrella

  https://www.charlesbonnetsyndrome.uk/managing-cbs

  For most people the approaches above are all that is needed but for some, Charles Bonnet Syndrome becomes so distressing and unpleasant that other treatments need to be given. Currently, there is no Charles Bonnet Syndrome-specific medication but, if the visual hallucinations are intolerable, there are several types of medication that can be tried. […] A study at Newcastle University shows that the occurrence of CBS hallucinations can be significantly reduced by the use of a non-invasive electrical brain stimulation technique that makes the visual parts of the brain less excitable although this is not yet available for routine clinical use.

• #36 Focus on Charles Bonnet Syndrome

  https://info.yourdolphin.com/charles-bonnet-syndrome

  In addition, treating any underlying eye conditions that are causing vision loss can help reduce the frequency and intensity of the hallucinations. This may involve surgery, medication, or other therapies. […] If the hallucinations are causing significant distress or interfering with daily activities, medications such as antipsychotics or antidepressants may be prescribed. However, these medications should be used with caution, as they can have side effects and may not be effective for all patients. […] Cognitive-behavioural therapy (CBT) is another treatment option that can help patients manage the anxiety and stress related to the hallucinations. This therapy focuses on changing negative thoughts and behaviours related to the hallucinations and can help patients develop coping skills and relaxation techniques.

• #37 Charles Bonnet Syndrome: what is it and what help is out there? | Glaucoma UK

  https://glaucoma.uk/blog-category-blog/charles-bonnet-syndrome-what-is-it-and-what-help-is-out-there/

  Creating Esme Room Support Groups was the first step to offer support. […] Out of the pandemic grew Esme’s Friends, which began as telephone or online support groups – hosted by local, low vision charities and the RNIB – and these continue face-to-face or in a hybrid version. […] Isolation, stress, fever and inactivity exacerbate CBS. Keeping the brain active can help to reduce the frequency of the episodes. […] Until our researchers discover a CBS-specific medication, distracting the brain may help to quell the hallucination temporarily. […] These include reaching out to the hallucination, clapping the hands, clicking the fingers, standing up/sitting down, walking about, singing, whistling, turning on/off music, television, radio or using Professor ffytche’s eye exercise, which can be found on the Esme’s Umbrella website.

• #38 Charles Bonnet syndrome (CBS) – Macular Society

  https://www.macularsociety.org/macular-disease/macular-conditions/charles-bonnet-syndrome/

  Preliminary findings suggest it is helpful in reducing the number of hallucinations experienced and there are few, if any, side effects but further research is needed to confirm this. […] What support is there for people with CBS? […] The Macular Society runs a CBS support group via our counselling service. […] Our helpline can give you advice and information on CBS. […] If you feel you or your family need more tailored support, our counselling service is able to give you a call to discuss one-to-one telephone or group sessions. […] Would you like to take part in a study designed to evaluate simple therapies for CBS?

• #39 Charles Bonnet Syndrome: Symptoms, management tips of eye condition that causes hallucinations | Health – Hindustan Times

  https://www.hindustantimes.com/lifestyle/health/charles-bonnet-syndrome-symptoms-management-tips-of-eye-condition-that-causes-hallucinations-101674718459941.html

  There is no recognised cure or effective treatment for Charles Bonnet syndrome. You may resort to some techniques to cope up with the condition. Dr Seth explains. […] Talk about your hallucinations while speaking to your therapist, your doctor, a friend or a family member. Sharing your hallucination experience with someone can make you feel less isolated. You may simply remind yourself or your loved one that the hallucinations occurred due to vision loss and not the result of a mental health problem. […] If you experience hallucinations more often in dim lighting or in brightly lit rooms, then change the environment. Changing the lighting conditions may help lower your hallucinations. For example, if hallucinations take place in dim light, you should turn on more lights or open the curtains. If you see hallucinations when its very quiet, you may turn on a TV or radio. […] To manage hallucinations, you may also move your eyes up-or-down or side-to-side (without moving your head), look away from the hallucinations, stare at the hallucinations, close your eyes and then open them, rest and relax. You may get plenty of sleep and do exercise, meditation to beat anxiety.

• #40 Charles Bonnet Syndrome | Psychology Today

  https://www.psychologytoday.com/us/basics/charles-bonnet-syndrome

  Hallucinations can worsen if you’re tired or stressed; making an effort to get enough sleep could help lessen their frequency. Keeping your home well-lit can also help; time spent in dark rooms has been shown to increase the risk of hallucinations. Finally, it’s important to keep up with routine eye exams, even if you’ve already lost a significant amount of vision; an eye doctor can help you stay ahead of any changes and better adapt to life with poorer sight.

• #41 Charles Bonnet Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/eye-care/charles-bonnet-syndrome

  Charles Bonnet syndrome treatment […] There is no cure for CBS. Doing the following can all help to reduce the frequency of hallucinations: […] Increasing lighting levels in the evening. […] Being active both physically and mentally. […] Spending more time in the company of others. […] Eye movements have been shown to lessen the impact and length of the hallucinations – see Macular Society in Further Reading (below). […] Anxiety treatments such as antidepressants are sometimes offered to those who find their symptoms upsetting. […] For most patients, understanding the cause of the symptoms – and realising that they are not becoming mentally ill – is all that is needed. […] Suggestions to try when having a CBS hallucination […] Eye movement exercise: […] Imagine two points about 3 feet apart on a wall in front of you.

• #42 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  A multidisciplinary patient-centred approach is required to manage CBS. Optimisation of vision, physician recognition, empathy, reassurance and patient education form the cornerstone of its treatment. Patients in whom the diagnosis is likely to be something other than CBS must then be referred to other specialists. Inappropriate admissions to a psychiatric ward must be avoided as it can lead to distress and stigma. […] Hallucinations attributed to CBS may disappear after the treatment of an underlying cause of visual impairment or blindness. Some patients may respond partially or completely to procedures such as cataract removal. Resolution is more likely with a combination of maximising remaining vision and removing or reducing the effects of adverse factors such as blur, glare and visual field loss. Interestingly, hallucinations may cease as visual deterioration progresses to total blindness. Environmental changes for example, improved lighting may reduce the hallucinations.

• #43 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  Learning that CBS is not related to mental illness often relieves patients. Patients must be given an opportunity to join a psychoeducation group where sufferers can be encouraged to meet, obtain reassurance and be given information and advice on specific techniques for reducing the duration of hallucinations; for example, closing or opening the eyes, blinking, putting on a light and developing distraction techniques. […] Treatment with psychotropic drugs remains controversial in CBS. Neuroleptics are only partially successful at eradicating the hallucinations. Systematic research into the pharmacological management of CBS has not been conducted. Previous studies of CBS have generally reported unsatisfactory results with medications. There have been several reports of successful treatment CBS using antidepressants (mirtazapine), typical antipsychotics (haloperidol), atypical antipsychotics (sulpiride, risperidone, olanzapine and aripiprazole), anticonvulsants (carbamazepine and valproate), cholinesterase inhibitors (donepezil), 5HT antagonists (ondanestron) and corticosteroids.

• #44 Charles Bonnet Syndrome: what is it and what help is out there? | Glaucoma UK

  https://glaucoma.uk/blog-category-blog/charles-bonnet-syndrome-what-is-it-and-what-help-is-out-there/

  Dr Kat da Silva Morgan – an Esme’s Research Fellow – led a study at Newcastle University which showed that the occurrence of CBS hallucinations can be significantly reduced by the use of a non-invasive electrical brain stimulation technique. Investment is needed now to optimise the treatment and allow it to be adopted by the NHS and used by people at home. […] Now, I am urging the NHS to create a pathway for diagnosis and treatment – with multi-disciplinary clinics so that CBS can be diagnosed correctly and swiftly.

• #45 Charles Bonnet Syndrome – Perceptual Neuroscience Laboratory

  https://www.yorku.ca/health/lab/steeves/charles-bonnet-syndrome/

  Charles Bonnet Syndrome (CBS) arises following vision loss from diseases causing blindness such as age-related macular degeneration (AMD) or glaucoma. […] presently there is no treatment. […] Associate Vice President of Research Professor Jennifer Steeves is investigating a therapeutic treatment using TMS to provide a safe and effective non-invasive therapy for visual hallucinations following loss of vision. […] This investigation from the Centre for Vision Research will offer the only existing treatment to improve the lives of people suffering from CBS hallucinations thereby significantly improving quality of life.

• #46 Eyes – Charles Bonnet syndrome | Better Health ChannelExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal Link

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-charles-bonnet-syndrome

  In most cases, Charles Bonnet syndrome resolves itself after about 12 to 18 months without treatment. […] Sometimes the hallucinations don’t go away, but there is no medical cure. Depending on the severity of the condition, treatment may include: Medical advice – talking it over with a doctor or counsellor can be helpful. Vision therapy – low-vision rehabilitation may help to ease symptoms. Moving your eyes – some people report that the hallucinations dissipate if they move their gaze from side to side or up and down. Changing the variables – to ‘turn off’ the hallucination, you could try altering the environment or setting that you are in. For example: if it’s dark, turn on the light, or if you’re standing up, sit down. If your eyes are open, shut them, or if you’re in one room, go to another room.

• #47 Negative outcome Charles Bonnet Syndrome | British Journal of Ophthalmology

  https://bjo.bmj.com/content/98/9/1236

  Charles Bonnet Syndrome (CBS) is widely considered a transient condition without adverse consequence, questioning the need for treatment. […] Interventions that reduce the frequency, duration or fear of individual hallucination episodes and education prior to hallucination onset may help reduce negative outcome. […] CBS can no longer be considered a homogeneous, transient condition. For most people with CBS, symptoms continue for many years with negative consequences in around a third. This changes CBS from a symptom that can be largely ignored by clinical services to one that needs further characterisation to identify those with negative outcome and offer appropriate interventions. The low priority given to CBS research to date means there is currently an absence of evidence as to what treatments might be effective. Our study suggests an alternative treatment goal to cessation of hallucinations might be to target negative outcome, reducing the duration, frequency, fear association and interference with activities of ongoing hallucinations to result in a more benign form of CBS. The findings also suggest negative outcome might be preventable, and the need for trials to examine the effectiveness of information/psychoeducation prior to the onset of hallucinations.

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