Stoppe G, Schreiner A, Schmitt A B
Universitäre Psychiatrische Kliniken Basel.
Dtsch Med Wochenschr. 2006 Mar 3;131(9):423-9. doi: 10.1055/s-2006-932536.
Up to 90% of the patients with dementia develop behavioral and psychological symptoms during the course of their illness. Since 1999 the atypical neuroleptic risperidone is the only drug approved by the German authorities for the treatment of aggressive behavior or psychotic symptoms of dementia, which was defined in March 2004 with respect to severe chronic aggressive behavior, endangering themselves or others, or impoverishing psychotic symptoms. This prospective investigation was aimed at detecting therapeutic efficacy and the tolerability of risperidone after changing from low-potency neuroleptics in patients, for whom the broader indications before March 2004 were still valid.
Symptoms, activities of daily living and caregivers" burden were documented for 6 weeks in 111 demented patients with chronic aggressive behavior and psychotic symptoms.
Marked improvements of psychotic symptoms, aggressiveness, other behavioral disorders and activities of daily living were observed. Furthermore, a substantial reduction of caregivers' burden was noted. The treatment with risperidone was well tolerated. No patient died and no cerebrovascular events were observed.
Changing the treatment of demented patients from low-potency neuroleptics to risperidone led to marked improvement of symptoms and to a substantial decrease of caregivers' burden.
高达90%的痴呆患者在病程中会出现行为和心理症状。自1999年以来，非典型抗精神病药物利培酮是德国当局批准用于治疗痴呆患者攻击行为或精神病性症状的唯一药物，2004年3月对其进行了定义，涉及严重慢性攻击行为、危及自身或他人，或严重精神病性症状。这项前瞻性研究旨在检测对于2004年3月之前更广泛适应证仍然有效的患者，从低效价抗精神病药物换用利培酮后的治疗效果和耐受性。
对111例有慢性攻击行为和精神病性症状的痴呆患者的症状、日常生活活动及照料者负担进行了6周的记录。
观察到精神病性症状、攻击性、其他行为障碍及日常生活活动有显著改善。此外，照料者负担显著减轻。利培酮治疗耐受性良好。无患者死亡，未观察到脑血管事件。
将痴呆患者的治疗从低效价抗精神病药物换用利培酮可使症状显著改善，照料者负担大幅减轻。
