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近年来,老年期精神病的药理学治疗取得了进展。

Recent advances in pharmacological treatment of psychosis in late life.

机构信息

Department of Psychiatry, Shatin Hospital, Chinese University of Hong Kong.

出版信息

Curr Opin Psychiatry. 2011 Nov;24(6):455-60. doi: 10.1097/YCO.0b013e32834a3f47.

Abstract

PURPOSE OF REVIEW

Psychosis is among the most frequent psychiatric symptoms in late life. Treatment of late life psychosis is often challenging because of age-related changes, physical comorbidities and frailty of older adults. The present study aims at reviewing recent literature on pharmacological treatment of psychosis in the older population.

RECENT FINDINGS

Recent studies show that antipsychotics remain the mainstay of treatment for older adults with psychosis. Although the efficacies of both typical and atypical antipsychotics have been demonstrated in older adults with schizophrenia, delirium and Parkinson's disease psychosis, there is a growing body of data favoring atypical antipsychotics. However, most of the evidence is not based on rigorously conducted trials. In addition, the use of antipsychotic medication in managing psychosis associated with dementia has declined significantly with the recognition of its serious adverse effects in this vulnerable population. A recent study suggests that effective alternative treatments are yet to be developed.

SUMMARY

Studies have demonstrated the clinical benefits of antipsychotics in older people with psychosis. The potential benefits from the use of antipsychotics must be weighed against their adverse effects.

摘要

目的综述

精神疾病是老年人中最常见的精神症状之一。由于老年人的年龄相关变化、身体合并症和虚弱,老年精神疾病的治疗常常具有挑战性。本研究旨在综述关于老年人群精神疾病的药物治疗的最新文献。

最近的发现

最近的研究表明,抗精神病药仍然是治疗老年精神疾病患者的主要方法。尽管典型和非典型抗精神病药在老年精神分裂症、谵妄和帕金森病性精神疾病患者中的疗效已得到证实,但越来越多的数据支持非典型抗精神病药。然而,大多数证据并非基于严格进行的试验。此外,由于认识到抗精神病药物在这一脆弱人群中的严重不良反应,在治疗与痴呆相关的精神疾病时,抗精神病药物的使用已显著下降。最近的一项研究表明,仍需要开发有效的替代治疗方法。

总结

研究表明,抗精神病药对老年精神病患者具有临床益处。必须权衡抗精神病药物的不良反应和潜在益处。

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