For children, grief is a process that unfolds over time. The physician should be aware of the range of manifestations of childhood grief and be alert to prolonged or severe behavior change that signals the need for more intensive intervention. The AAP committee feels that referral to a mental health professional or clergy should be considered when progress is not being made or if the physician would feel more comfortable having someone else work with the family. Rivastigmine has been found to improve a patient's daily functioning, behavior and cognition. According to the manufacturer, rivastigmine is a cholinesterase inhibitor that blocks the breakdown of an important neurotransmitter called acetylcholine.
Cholinesterase breaks down and inactivates acetylcholine.
By inhibiting cholinesterase, more acetylcholine is available for normal memory-related and cognitive functioning. In clinical trials, patients who used rivastigmine showed significant improvement in areas such as average total word recall and recognition, orientation and ability to speak when compared with patients treated with placebo. In patients who used rivastigmine, the most common side effects included nausea, vomiting, anorexia, dyspepsia and asthenia. These side effects were usually transient and mild to moderate in severity. Adverse reactions were generally less frequent later in the course of treatment.