Savaskan Egemen
Klinik für Alterspsychiatrie, Psychiatrische Universitätsklinik Zürich.
Ther Umsch. 2015 Apr;72(4):255-60. doi: 10.1024/0040-5930/a000673.
The prevalence of the behavioral and psychological symptoms of dementia (BPSD) is very high in dementia patients. Alterations in multiple neurotransmitter systems are involved in the pathogenesis of BPSD. These symptoms complicate the therapy and outcome. Because of multimorbidity and polpharmacy the therapy of BPSD is difficult and needs continuous clinical observation of the patients. Non-pharmacological interventions must be the first choice of therapy before medication and may accompany the pharmacological treatment. Several non-pharmacological interventions are available and summarized in the following therapy recommendations of the Swiss medical societies. Pharmacological interventions are often accompanied by severe adverse events in dementia patients. Their use must be limited in time and quantity. A critical survey of pharmacological therapy options in dementia is necessary.
痴呆患者中痴呆的行为和心理症状（BPSD）的患病率非常高。多种神经递质系统的改变参与了BPSD的发病机制。这些症状使治疗和预后复杂化。由于合并多种疾病和多种药物治疗，BPSD的治疗困难，需要对患者进行持续的临床观察。非药物干预必须在用药前作为首选治疗方法，并且可以与药物治疗同时进行。有几种非药物干预方法可供选择，并总结在瑞士医学协会的以下治疗建议中。药物干预在痴呆患者中常常伴有严重的不良事件。其使用必须在时间和剂量上加以限制。对痴呆的药物治疗选择进行批判性审视是必要的。
