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使用利培酮治疗阿尔茨海默病性精神病患者的行为和心理症状。

Treating behavioral and psychological symptoms in patients with psychosis of Alzheimer's disease using risperidone.

作者信息

Rabinowitz Jonathan, Katz Ira, De Deyn Peter Paul, Greenspan Andrew, Brodaty Henry

机构信息

Bar Ilan University, Ramat Gan, Israel.

出版信息

Int Psychogeriatr. 2007 Apr;19(2):227-40. doi: 10.1017/S1041610206003942. Epub 2006 Jul 31.

Abstract

OBJECTIVES

To examine the effect of risperidone on specific behavioral and psychological symptoms of dementia (BPSD) among patients with psychosis of Alzheimer's disease (AD).

METHODS

Post hoc exploratory analysis of data on 479 nursing-home patients with psychosis of AD from three 12-week, double-blind, placebo-controlled clinical trials. Criteria for psychosis of AD were a diagnosis of AD or mixed dementia and a rating of >/= 2 on any delusion or hallucination item of the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) rating scale when entering the trial. Mean changes from baseline to endpoint were examined for items on the Cohen-Mansfield Agitation Inventory (CMAI) and BEHAVE- AD.

RESULTS

On the CMAI, risperidone was significantly more effective than placebo in treating cursing or verbal aggression (p = 0.004), hitting (p < 0.001), performing repetitious mannerisms (p < 0.001), pacing, aimless wandering (p = 0.017), hoarding things (p = 0.02), hiding things (p = 0.02) and repetitive sentences or questions (p = 0.025). On the BEHAVE-AD, risperidone was significantly more effective than placebo in treating physical threats and/or violence (p = 0.001), agitation (other) (p = 0.001) and verbal outbursts (p = 0.026). Although analysis on individual hallucination and delusional items did not demonstrate specific responses, analyses of a composite of delusional items revealed significant drug-placebo differences.

CONCLUSIONS

These data indicate that risperidone is effective in treating a variety of symptoms associated with psychosis of AD.

摘要

目的

研究利培酮对阿尔茨海默病(AD)伴精神病患者特定痴呆行为和心理症状(BPSD)的影响。

方法

对来自三项为期12周的双盲、安慰剂对照临床试验的479名AD伴精神病的疗养院患者的数据进行事后探索性分析。AD伴精神病的标准为确诊为AD或混合性痴呆,且在进入试验时,阿尔茨海默病行为病理学(BEHAVE-AD)评定量表的任何妄想或幻觉项目评分≥2分。检查了科恩-曼斯菲尔德激越量表(CMAI)和BEHAVE-AD项目从基线到终点的平均变化。

结果

在CMAI上,利培酮在治疗咒骂或言语攻击(p = 0.004)、殴打(p < 0.001)、表现出重复的怪癖(p < 0.001)、踱步、无目的徘徊(p = 0.017)、囤积物品(p = 0.02)、藏匿物品(p = 0.02)以及重复语句或问题(p = 从基线到终点的平均变化。

结果

在CMAI上,利培酮在治疗咒骂或言语攻击(p = 0.004)、殴打(p < 0.001)、表现出重复的怪癖(p < 0.001)、踱步(p = 0.017)、无目的徘徊(p = 0.017)、囤积物品(p = 0.02)、藏匿物品(p = 0.02)以及重复语句或问题(p = 0.025)方面比安慰剂显著更有效。在BEHAVE-AD上,利培酮在治疗身体威胁和/或暴力(p = 0.001)、激越(其他)(p = 0.001)和言语爆发(p = 0.026)方面比安慰剂显著更有效。虽然对个别幻觉和妄想项目的分析未显示出特定反应,但对妄想项目综合分析显示药物与安慰剂之间存在显著差异。

结论

这些数据表明利培酮对治疗与AD伴精神病相关的多种症状有效。

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