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老年痴呆患者使用非典型抗精神病药物

[Atypical antipsychotics in elderly patients with dementia].

作者信息

Selbaek Geir, Engedal Knut

机构信息

Alderspsykiatrisk kompetansesenter, Sykehuset Innlandet, Postboks 68, 2312 Ottestad.

出版信息

Tidsskr Nor Laegeforen. 2008 May 1;128(9):1060-1.

Abstract

Antipsychotic medication is often prescribed to persons with dementia exhibiting behavioural and psychological symptoms (BPSD). Use of atypical antipsychotics in elderly persons with dementia is associated with an increased risk of serious cerebrovascular adverse events and increased mortality. Based on a review of available literature, we conclude that atypical antipsychotics have a modest effect on BPSD and potentially serious side effects and that conventional antipsychotics appear to have even less favourable effects and adverse event profiles. Antipsychotic medication in patients with dementia exhibiting BPSD should only be prescribed for short-term treatment of severe symptoms associated with considerable distress or serious risk. Non-pharmacological interventions should be the first-line treatment approach in most cases.

摘要

抗精神病药物常被开给患有痴呆症且表现出行为和心理症状(BPSD)的患者。在患有痴呆症的老年人中使用非典型抗精神病药物与严重脑血管不良事件风险增加及死亡率上升有关。基于对现有文献的综述,我们得出结论:非典型抗精神病药物对BPSD有一定作用,但存在潜在的严重副作用,而传统抗精神病药物的效果似乎更不理想,不良事件也更多。对于患有痴呆症且表现出BPSD的患者,抗精神病药物仅应在短期用于治疗与严重痛苦或严重风险相关的严重症状。在大多数情况下,非药物干预应作为一线治疗方法。

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