Miarons Marta, Cabib Christopher, Barón Francisco Javier, Rofes Laia
Department of Pharmacy, Mataró Hospital, Mataró, Spain.
Gastrointestinal Physiology Laboratory, Mataró Hospital, Mataró, Spain.
Eur J Clin Pharmacol. 2017 Nov;73(11):1389-1398. doi: 10.1007/s00228-017-2314-3. Epub 2017 Aug 5.
Antipsychotics (APs) are commonly used to manage neuropsychiatric symptoms (NPS) in elderly patients with dementia, even though several large studies have demonstrated an association between AP treatment and increased morbidity and mortality in people with dementia. The aim of this study is to review the scientific literature of the use of AP in the elderly with dementia and to propose an algorithm to assist in decision-making regarding the withdrawal of APs.
A computerized literature search (MEDLINE: 1966 to December 2016, EMBASE: 1982 to December 2016) was used to locate relevant literature. Keywords in the search included terms from Medical Subject Headings (MESH) and EMBASE thesaurus (EMTREE). The following terms were used in the MESH database and EMTREE thesaurus: Aged, Antipsychotic Agents, Behavioral Symptoms and Dementia.
Earlier studies of APs used in elderly patients with dementia suggest that, in most elderly demented patients, APs can be withdrawn with no effect on behaviour. These patients are likely to benefit from the algorithm we propose to assist clinicians in the withdrawal of APs.
In this paper, we review the potential risks and benefits of discontinuing AP treatment in elderly demented patients with NPS and propose an algorithm to assist in decision-making regarding AP withdrawal.
抗精神病药物（APs）常用于治疗老年痴呆患者的神经精神症状（NPS），尽管多项大型研究表明，AP治疗与痴呆患者发病率和死亡率增加之间存在关联。本研究的目的是回顾使用AP治疗老年痴呆患者的科学文献，并提出一种算法，以协助做出关于停用APs的决策。
通过计算机文献检索（MEDLINE：1966年至2016年12月，EMBASE：1982年至2016年12月）来查找相关文献。检索关键词包括医学主题词表（MESH）和EMBASE词库（EMTREE）中的术语。MESH数据库和EMTREE词库中使用了以下术语：老年人、抗精神病药物、行为症状和痴呆。
早期关于老年痴呆患者使用APs的研究表明，在大多数老年痴呆患者中，停用APs对行为没有影响。这些患者可能会从我们提出的协助临床医生停用APs的算法中受益。
在本文中，我们回顾了停用AP治疗老年痴呆伴NPS患者的潜在风险和益处，并提出一种算法，以协助做出关于停用APs的决策。
