Alagiakrishnan Kannayiram
Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton T6G 2G3, Canada.
Discov Med. 2016 May;21(117):363-71.
Melatonin levels have been shown to decline with aging. Melatonin and its analogs in addition to their effect on sleep promotion, has been shown to have multiple pleiotropic effects. It can also help with neuroprotection through different mechanisms. Evidence in animal and human studies suggests that low levels of melatonin have been linked to delirium, mild cognitive impairment, dementia, and with certain behavioral problems. Recent clinical trials have showed that both melatonin and its analogs may be useful in the prevention, treatment of delirium, and the management of dementia. These medications seem to have the advantage of less side effects and better safety profile when compared to antipsychotics and sedatives like benzodiazepines. These medications are available over the counter in North America, Europe, and Asia, and some of these medications are approved by FDA. This manuscript will discuss the promising role of these melatonergic medications alone or in combination with other medications for the management of Geriatric Psychiatric diseases like delirium and dementia.
褪黑素水平已被证明会随着年龄增长而下降。褪黑素及其类似物除了具有促进睡眠的作用外，还被证明具有多种多效性作用。它还可以通过不同机制帮助进行神经保护。动物和人体研究的证据表明，低水平的褪黑素与谵妄、轻度认知障碍、痴呆以及某些行为问题有关。最近的临床试验表明，褪黑素及其类似物在预防、治疗谵妄和管理痴呆方面可能有用。与抗精神病药物和苯二氮䓬类镇静剂相比，这些药物似乎具有副作用更少、安全性更高的优势。这些药物在北美、欧洲和亚洲都可以非处方购买，其中一些药物已获得美国食品药品监督管理局（FDA）的批准。本手稿将讨论这些褪黑素能药物单独使用或与其他药物联合使用在管理老年精神疾病如谵妄和痴呆方面的前景。
