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痴呆症的药物治疗。

Drug treatments of dementia.

作者信息

Whalley L J

机构信息

Edinburgh University Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park.

出版信息

Br J Psychiatry. 1989 Nov;155:595-611. doi: 10.1192/s0007125000018079.

Abstract

Present drug treatments for the more common types of dementia are largely palliative or symptomatic, but the promise of drugs to prevent the development of dementia does not seem unrealistic. Neuropharmacological strategies that aim to improve behavioural or cognitive symptoms in dementia are subdivided into drugs that modify central cholinergic, serotonergic, dopaminergic, GABAnergic, and peptidergic transmission. There are no clear clinical guidelines for the management of demented patients who are also hypertensive. The early identification of patients with incipient dementia, the detection of slight but theoretically important beneficial effects, the optimum method of drug administration, more soundly based treatment of behavioural symptoms, and the evaluation of drug combinations are all identified as areas requiring further research.

摘要

目前针对更常见类型痴呆症的药物治疗在很大程度上是姑息性的或对症治疗,但药物预防痴呆症发展的前景似乎并非不切实际。旨在改善痴呆症行为或认知症状的神经药理学策略可细分为改变中枢胆碱能、血清素能、多巴胺能、γ-氨基丁酸能和肽能传递的药物。对于同时患有高血压的痴呆患者,目前尚无明确的临床管理指南。早期识别早期痴呆患者、检测轻微但理论上重要的有益效果、最佳给药方法、基于更合理依据的行为症状治疗以及药物组合评估,均被确定为需要进一步研究的领域。

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