Ikeda Manabu
Department of Neuropsychiatry, Ehime University School of Medicine.
Rinsho Shinkeigaku. 2005 Nov;45(11):861-3.
Interventional studies, with the aim of reducing the burden of care through drug or non-drug therapies of behavioral and psychological symptoms of dementia (BPSD), have been scarce. However, we are now able to do pharmacological management for BPSD with new drugs such as atypical neuroleptics, SSRIs, and cholinesterase inhibitors. Delusions of theft are one of the most frequently observed BPSD in patients with AD. In addition, the delusions and ensuing aggression and anxiety are major factors that increase the burden of caregivers. Delusions of theft in patients with AD were eliminated or reduced with low-dose atypical neuroleptics (risperidone). This significantly reduced the burden of care overall for caregivers. New therapeutic strategies such as cholinesterase inhibitors for visual hallucinations in DLB and SSRIs for overeating and stereotyped behavior in FTLD might also remarkably reduce the burden of care for these patients. For many dementia patients, there are still no drugs that offer a principal cure. It is, therefore, important to evaluate their BPSD correctly at the earliest possible time, so that the burden of caring can be reduced through appropriate drug treatment. This reduction is critical for the continuation of satisfactory at-home care and might contribute to the health economics.
旨在通过药物或非药物疗法减轻痴呆行为和心理症状（BPSD）护理负担的干预性研究一直很少。然而，我们现在能够使用非典型抗精神病药、选择性5-羟色胺再摄取抑制剂（SSRI）和胆碱酯酶抑制剂等新药对BPSD进行药物管理。盗窃妄想是阿尔茨海默病（AD）患者中最常见的BPSD之一。此外，妄想以及随之而来的攻击行为和焦虑是增加护理人员负担的主要因素。低剂量非典型抗精神病药（利培酮）可消除或减轻AD患者的盗窃妄想。这显著减轻了护理人员的总体护理负担。新的治疗策略，如用于路易体痴呆（DLB）视幻觉的胆碱酯酶抑制剂，以及用于额颞叶痴呆（FTLD）暴饮暴食和刻板行为的SSRI，也可能显著减轻这些患者的护理负担。对于许多痴呆患者来说，仍然没有能提供主要治愈方法的药物。因此，尽早正确评估他们的BPSD很重要，这样可以通过适当的药物治疗减轻护理负担。这种减轻对于持续提供令人满意的居家护理至关重要，并且可能有助于卫生经济学。
