Jenike M A
Harvard Medical School, Boston, Massachusetts.
Geriatrics. 1988 Sep;43(9):53-7, 61-2, 65.
Psychiatric disorders in the elderly are common and often overlap with multiple medical problems. If used inappropriately, psychotropic drugs can further compromise a difficult clinical situation. Management of elderly patients with agitation, psychosis, anxiety, and insomnia are reviewed with a discussion of the optimal use of antipsychotic, anxiolytic, and sedating drugs. Initial attempts to control symptoms should involve nonpharmacologic techniques, but, when absolutely required, psychotropic drugs will often relieve symptoms with a minimum of side effects. Dangers in the chronic use of neuroleptics are stressed.
老年精神障碍很常见,且常常与多种躯体问题并存。如果使用不当,精神药物会使本就棘手的临床状况进一步恶化。本文回顾了老年激越、精神病性、焦虑和失眠患者的管理,并讨论了抗精神病药、抗焦虑药和镇静催眠药的最佳使用方法。控制症状的初始尝试应采用非药物技术,但在绝对必要时,精神药物通常能以最小的副作用缓解症状。文中强调了长期使用抗精神病药物的风险。