López-Pousa Secundino, Garre-Olmo Josep, Vilalta-Franch Joan, Turon-Estrada Antoni, Pericot-Nierga Imma
Research Unit, Institut d'Assistència Sanitària, Hospital Santa Caterina, Parc Hospitalari Martí i Julià, C/Dr. Castany s/n, 17190 Salt, Girona, Spain.
Arch Gerontol Geriatr. 2008 Sep-Oct;47(2):207-15. doi: 10.1016/j.archger.2007.07.010. Epub 2007 Sep 25.
This study intended to provide a patient profile for trazodone (a triazolopyridine-derivative of phenylpiperazine) prescription in everyday clinical practice in patients with Alzheimer's disease (AD), and to describe clinical evaluation and the impact on caregiver burden at a 6-month follow-up. A naturalistic, prospective and observational study was performed, with a 6-month follow-up in 396 patients with probable AD, according to the NINCDS-ARDRA criteria. At the baseline and at the 6-month visit, patients were administered the Neuropsychiatric Inventory (NPI) to determine their Behavioral and Psychological Symptoms of Dementia (BPSD), and the Zarit Burden Interview (ZBI) to assess the impact on caregiver burden. Trazodone was prescribed for 6.1% of patients. With respect to the baseline visit, the untreated group showed an increased global NPI score (3.1 points; 95% CI=1.9-4.2; p=0.001) and ZBI score (2.2 points; 95% CI=0.9-3.4; p=0.001). At 6 months, the global NPI and ZBI scores remained unchanged for the treated group. The treated group showed a significant reduction in the NPI irritability subscale score (2.1 points; 95% CI=0.4-3.7; p=0.015). In the clinical practice, trazodone treatment was prescribed for patients with irritability, agitation and disinhibition. After 6 months, patients treated with trazodone exhibited no increase in BPSD frequency or severity, nor was an increase noted in the caregiver burden.
本研究旨在提供阿尔茨海默病（AD）患者在日常临床实践中使用曲唑酮（一种苯基哌嗪的三唑并吡啶衍生物）的患者概况，并描述临床评估以及6个月随访时对照顾者负担的影响。根据NINCDS-ARDRA标准，对396例可能患有AD的患者进行了一项自然主义、前瞻性和观察性研究，并进行了6个月的随访。在基线和6个月随访时，对患者进行神经精神科问卷（NPI）以确定其痴呆的行为和心理症状（BPSD），并进行 Zarit 负担访谈（ZBI）以评估对照顾者负担的影响。6.1%的患者使用了曲唑酮。与基线访视相比，未治疗组的NPI总分升高（3.1分；95%CI=1.9-4.2；p=0.001），ZBI总分升高（2.2分；95%CI=0.9-3.4；p=0.001）。在6个月时，治疗组的NPI和ZBI总分保持不变。治疗组的NPI激惹分量表得分显著降低（2.1分；95%CI=0.4-3.7；p=0.015）。在临床实践中，曲唑酮治疗用于有激惹、躁动和脱抑制症状的患者。6个月后，接受曲唑酮治疗的患者BPSD的频率或严重程度没有增加，照顾者负担也没有增加。
