Tariot Pierre N, Ismail M Saleem
Department of Psychiatry, University of Rochester School of Medicine, Monroe Community Hospital, Rochester, NY 14620, USA.
J Clin Psychiatry. 2002;63 Suppl 13:21-6.
Behavioral problems associated with psychosis in the elderly have a significant negative impact on patients' quality of life and can lead to placement in a nursing home. Because of their decreased propensity to produce extrapyramidal symptoms, atypical antipsychotics such as quetiapine hold promise in the treatment of these vulnerable patients. Quetiapine may, in theory, be particularly advantageous in this regard because of its lack of anticholinergic activity and its relatively loose binding to dopamine receptors. This article reviews the somewhat limited number of clinical studies of the use of quetiapine in treating older patients with schizophrenia and other psychotic disorders, patients with psychosis associated with Alzheimer's disease or dementia with Lewy bodies, and patients with Parkinson's disease and drug-induced psychosis.
老年人中与精神病相关的行为问题会对患者的生活质量产生重大负面影响,并可能导致其被安置在养老院。由于非典型抗精神病药物(如喹硫平)产生锥体外系症状的倾向较低,因此在治疗这些脆弱患者方面具有前景。理论上,喹硫平在这方面可能特别有利,因为它缺乏抗胆碱能活性,并且与多巴胺受体的结合相对松散。本文综述了使用喹硫平治疗老年精神分裂症患者和其他精神障碍患者、患有与阿尔茨海默病或路易体痴呆相关精神病的患者以及帕金森病和药物性精神病患者的临床研究数量有限的情况。