Fahs H, Potiron G, Senon J L, Perivier E
Service Universitaire de Psychiatrie de l'Adulte, Centre Hospitalier Henri-Laborit, Pavillon Toulouse, Poitiers.
Encephale. 1999 Mar-Apr;25(2):169-74.
Aggressive agitation, agitation and insomnia with generalized anxiety are commonly observed in Alzheimer's disease. These symptoms remain a principal problem in the clinical management of elderly patients. Neuroleptics are commonly the selected medication for controlling severe aggression, especially the violent out bursts often seen in demented patients. Their use is frequently complicated by side effects, particularly somnolence and confusion. Valpromide and Carbamazepine have been efficacy alternatives and very well tolerated. We report eight cases of demented patients who presented an agitation and aggressive behaviors and had been treated with Valpromide or Carbamazepine. The patients agitation was well controlled at that point and had no apparent side effects. A combination Valpromide or Carbamazepine with neuroleptics permitted a reduction doses of neuroleptics and their side effects. We think that these behaviors disorders belong to the mood disorders. The symptomatology is modified because an alteration of cognitive faculty.
在阿尔茨海默病中，常可见到激越性躁动、伴有广泛性焦虑的躁动和失眠。这些症状仍是老年患者临床管理中的主要问题。抗精神病药物通常是控制严重激越症状的首选药物，尤其是痴呆患者中常见的暴力发作。其使用常因副作用而复杂化，尤其是嗜睡和意识模糊。丙戊酰胺和卡马西平是有效的替代药物，且耐受性良好。我们报告了8例患有躁动和攻击行为的痴呆患者，他们接受了丙戊酰胺或卡马西平治疗。此时患者的躁动得到了很好的控制，且无明显副作用。丙戊酰胺或卡马西平与抗精神病药物联合使用可减少抗精神病药物的剂量及其副作用。我们认为这些行为障碍属于心境障碍。由于认知功能的改变，症状表现有所改变。
