Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
Curr Opin Psychiatry. 2012 Nov;25(6):542-50. doi: 10.1097/YCO.0b013e328358e4f2.
In this article, we discuss new data on currently licensed drugs for dementia and novel developments in the management of neuropsychiatric symptoms in patients with dementia.
During the last years, a large body of evidence has been accumulated to support the use of antidementia medication in patients with severe Alzheimer's disease. Combination therapy with acetylcholinesterase inhibitors and memantine for Alzheimer's disease remains controversial, as controlled trials have yielded conflicting results. Memantine is not indicated in patients with mild Alzheimer's disease. Studies on memantine for Parkinson's disease dementia and dementia with Lewy bodies were inconclusive. In adult patients with dementia in the context of Down syndrome, memantine is not effective, and further studies on acetylcholinesterase inhibitors are warranted. There is still no treatment established for patients with vascular or frontotemporal dementia. The efficacy of antidepressants to treat depression associated with dementia is not proven. Treatment of agitation and psychosis in patients with dementia remains a challenge.
Recent systematic clinical reviews and new research on currently available treatment options provide valuable assistance for clinicians to deal with frequent clinical problems in the context of dementia.
本文讨论了目前用于痴呆症的已许可药物的新数据以及痴呆症患者神经精神症状管理方面的新进展。
在过去的几年中，大量证据支持在严重阿尔茨海默病患者中使用抗痴呆药物。乙酰胆碱酯酶抑制剂与美金刚联合治疗阿尔茨海默病仍然存在争议，因为对照试验得出了相互矛盾的结果。美金刚不适用于轻度阿尔茨海默病患者。关于美金刚治疗帕金森病痴呆和路易体痴呆的研究尚无定论。在唐氏综合征相关成年痴呆患者中，美金刚无效，需要进一步研究乙酰胆碱酯酶抑制剂。对于血管性或额颞叶痴呆患者，尚无既定的治疗方法。抗抑郁药治疗与痴呆相关的抑郁症的疗效尚未得到证实。治疗痴呆患者的激越和精神病仍然是一个挑战。
最近的系统临床综述和新的研究提供了有价值的帮助，为临床医生在痴呆症背景下处理常见的临床问题提供了宝贵的帮助。
