Rosen J, Bohon S, Gershon S
Western Psychiatric Institute and Clinic, Pittsburgh, PA.
Acta Psychiatr Scand Suppl. 1990;358:170-5. doi: 10.1111/j.1600-0447.1990.tb05312.x.
Neuroleptics are commonly prescribed medications in the geriatric population and have a broader spectrum of indications than in younger patients. In spite of the frequent use of neuroleptics in elderly patients with organic brain syndromes, there are relatively few studies that use double-blind, placebo-controlled methodology. The results of these studies are conflicting; however, there is sufficient evidence that symptoms of agitation, behaviourial dyscontrol, and psychosis are often responsive to neuroleptic treatment. Elderly patients with schizophrenia or other psychotic disorders may also benefit from neuroleptic treatment. As there is a potential for overuse of these medications among the elderly, clear definition of checklist symptoms is imperative. Furthermore, periodic reduction of dose and possible discontinuation of the drug should be considered since many of the checklist symptoms in this age group are environmentally related and time-limited. There has so far been little evidence to support the use of one neuroleptic over another. Side-effect profiles suggest that low doses of the high potency agents are safer and better tolerated in the elderly. Both therapeutic effects and side effects should be assessed at regular intervals.
抗精神病药物是老年人群中常用的处方药，其适应症范围比年轻患者更广。尽管抗精神病药物在患有器质性脑综合征的老年患者中经常使用，但采用双盲、安慰剂对照方法的研究相对较少。这些研究的结果相互矛盾；然而，有足够的证据表明，激越、行为失控和精神病症状通常对抗精神病药物治疗有反应。患有精神分裂症或其他精神障碍的老年患者也可能从抗精神病药物治疗中获益。由于这些药物在老年人中存在过度使用的可能性，因此必须明确界定清单症状。此外，由于该年龄组的许多清单症状与环境有关且有时间限制，应考虑定期减少剂量并可能停药。到目前为止，几乎没有证据支持使用一种抗精神病药物优于另一种。副作用情况表明，低剂量的高效能药物在老年人中更安全且耐受性更好。应定期评估治疗效果和副作用。
