Madhusoodanan Subramoniam, Sinha Abhishek, Sajatovic Martha, Gupta Sanjay, Brenner Ronald
State University of New York, Health Science Center at Brooklyn, NY, USA.
Curr Drug Saf. 2006 Aug;1(3):227-41. doi: 10.2174/157488606777934468.
Schizophrenia and schizoaffective disorder are prevalent in 1% of the adult population. The condition was thought to predominantly affect the young however recent studies have shown that the condition occurs in individuals throughout the life-span. The aim of this review is to discuss the role of atypical antipsychotics in treating schizoaffective disorder and schizophrenia in the elderly. The advent of atypical antipsychotics has made significant strides in the pharmacotherapy of schizophrenia in the elderly. They are as efficacious as conventional agents in reducing the positive symptoms, possibly some what more efficacious in reducing negative symptoms and appear to have a relatively safer adverse effect profile. However metabolic side affects particularly glucose abnormalities and weight gain, cerebrovascular effects, and mortality risk noted in dementia patients are gaining increasing attention. Appropriate monitoring for the metabolic side effects has been recommended by agencies such as the FDA (United States Food and Drug Administration), ADA (American Diabetic Association) and APA (American Psychiatric Association). Treatment of elderly patients is complicated by age related biological factors affecting drug response and presence of comorbid medical conditions and concomitant medication. Current research supports the role of atypical antipsychotics in the treatment of schizophrenia and schizoaffective disorder in the elderly. Despite advantages compared with conventional agents, challenges to successful therapy remain, even with these better tolerated agents.
精神分裂症和分裂情感性障碍在1%的成年人口中普遍存在。这种疾病曾被认为主要影响年轻人，但最近的研究表明，它在人的一生各个阶段都有发生。这篇综述的目的是讨论非典型抗精神病药物在治疗老年分裂情感性障碍和精神分裂症中的作用。非典型抗精神病药物的出现使老年精神分裂症的药物治疗取得了重大进展。它们在减轻阳性症状方面与传统药物一样有效，在减轻阴性症状方面可能更有效一些，而且似乎不良反应相对较少。然而，代谢副作用，特别是血糖异常和体重增加、脑血管影响以及痴呆患者中出现的死亡风险越来越受到关注。美国食品药品监督管理局（FDA）、美国糖尿病协会（ADA）和美国精神病学协会（APA）等机构已建议对代谢副作用进行适当监测。老年患者的治疗因影响药物反应的年龄相关生物学因素以及合并的内科疾病和同时服用的药物而变得复杂。目前的研究支持非典型抗精神病药物在治疗老年精神分裂症和分裂情感性障碍中的作用。尽管与传统药物相比有优势，但即使使用这些耐受性较好的药物，成功治疗仍面临挑战。
