Wolf H, Gertz H J
Klinik und Poliklinik für Psychiatrie der Universität Leipzig.
MMW Fortschr Med. 2004 Jun 10;146(24):43-5.
Non-cognitive disorders and behavioral disturbances in dementia syndromes are the domain of antidepressants and neuroleptic agents. At the present time, neuroleptics are being prescribed too often and antidepressants too rarely. The choice of antidepressant depends upon whether a sedative effect is desired. Although caution is advised when increasing the dose, the target dose does not differ from that for young adults. Neuroleptics should always be administered in the lowest effective dose. In principle, the modern atypical substances should be preferred to the classical neuroleptics. Restraint should be exercised with the prescription of benzodiazepines in patients with dementia.
痴呆综合征中的非认知障碍和行为紊乱属于抗抑郁药和抗精神病药物的治疗范畴。目前,抗精神病药物的处方开具过于频繁,而抗抑郁药的使用则过少。抗抑郁药的选择取决于是否需要镇静作用。尽管增加剂量时需谨慎,但目标剂量与年轻成年人并无差异。抗精神病药物应始终以最低有效剂量给药。原则上,应优先选用现代非典型药物而非经典抗精神病药物。对于痴呆患者,开具苯二氮䓬类药物时应谨慎。