帕金森病性精神病的病程、预后及管理：当前治疗方法真的有效吗？
Course, prognosis, and management of psychosis in Parkinson's disease: are current treatments really effective?
作者信息
Zahodne Laura B, Fernandez Hubert H
机构信息
Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
出版信息
CNS Spectr. 2008 Mar;13(3 Suppl 4):26-33. doi: 10.1017/s1092852900017296.
It is essential to recognize and treat psychosis in Parkinson's disease for several reasons. Studies have shown that psychosis in Parkinson's disease patients is a strong risk factor for nursing home placement. Psychosis may be the greatest source of stress for caretakers of Parkinson's patients; it is often persistent, and its presence markedly increases mortality. Treatment of psychotic symptoms should occur only after potential medical and environmental causes of delirium have been eliminated or addressed. Initial pharmacologic changes should include limiting the patient's antiparkinsonian medications to those that are necessary to preserve motor function. Should that fail, an atypical antipsychotic is presently the treatment of choice. An emerging treatment option is acetylcholinesterase inhibitors. This article reviews what is currently known about the course, prognosis, and treatment strategies in Parkinson's disease psychosis.
出于多种原因，认识并治疗帕金森病中的精神病至关重要。研究表明，帕金森病患者的精神病是入住养老院的一个重要风险因素。精神病可能是帕金森病患者照料者最大的压力来源；它往往持续存在，其存在会显著增加死亡率。只有在排除或处理了谵妄的潜在医学和环境原因之后，才应进行精神病症状的治疗。初始药物调整应包括将患者的抗帕金森病药物限制在维持运动功能所需的药物范围内。如果这一方法失败，目前非典型抗精神病药物是首选治疗方法。一种新兴的治疗选择是乙酰胆碱酯酶抑制剂。本文综述了目前关于帕金森病精神病的病程、预后和治疗策略的已知情况。
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