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使用精神药物治疗巴西阿尔茨海默病患者的激越和攻击行为:一项自然主义和多中心研究。

Use of psychotropic agents to treat agitation and aggression in Brazilian patients with Alzheimer's disease: A naturalistic and multicenter study.

机构信息

Secretaria de Estado de Saúde do Distrito Federal, Geriatra(Staff geriatrician, Federal District Department of Health), Brasília, DF, Brazil.

Hospital Universitário de Brasília, Geriatra(Staff geriatrician, University Hospital of Brasilia), Brasília, DF, Brazil.

出版信息

Psychiatry Res. 2021 Jan;295:113591. doi: 10.1016/j.psychres.2020.113591. Epub 2020 Nov 25.

Abstract

We assessed psychotropic prescribing patterns in the clinical treatment of agitation and aggressive behavior in patients with Alzheimer's disease (AD) treated at specialist outpatient clinics in the Federal District of Brazil. This was a naturalistic, observational, multicenter study of a convenience sample of patients with AD (according to DSM-5) who had behavioral symptoms of aggression and/or agitation at outpatient visits, as assessed by the Neuropsychiatric Inventory (NPI), and required pharmacologic intervention. Participants were recruited in 2018-2019 from 11 AD treatment centers. Sociodemographic and clinical data were collected during routine visits. The sample consisted of 369 older adults with a mean age of 82.3 (SD, 7.7) years. The medications most commonly used in patients with behavioral disorders were antidepressants (79.1%), antipsychotics (70.2%), benzodiazepines (10.6%), and mood stabilizers (9.5%). Quetiapine was the most frequently prescribed antipsychotic medication (48.5%), at a mean dose of 57.4 (SD, 40.7) mg. Citalopram was the most widely used antidepressant medication (32.0%), at a mean daily dose of 24.1 (SD, 8.1) mg. In this sample, two or more pharmacologic agents were frequently used together to control aggression and agitation. Benzodiazepine was not frequently used.

摘要

我们评估了在巴西联邦区的专科门诊对阿尔茨海默病(AD)患者的激越和攻击行为的临床治疗中精神药物的处方模式。这是一项自然观察、多中心研究,对在门诊就诊时存在攻击和/或激越行为的 AD 患者(根据 DSM-5)进行了方便抽样,这些行为症状通过神经精神病学问卷(NPI)进行评估,并需要药物干预。研究参与者于 2018-2019 年在 11 个 AD 治疗中心招募。在常规就诊时收集了社会人口统计学和临床数据。样本包括 369 名平均年龄为 82.3(SD,7.7)岁的老年人。在有行为障碍的患者中最常使用的药物是抗抑郁药(79.1%)、抗精神病药(70.2%)、苯二氮䓬类药物(10.6%)和情绪稳定剂(9.5%)。喹硫平是最常开的抗精神病药(48.5%),平均剂量为 57.4(SD,40.7)mg。西酞普兰是最广泛使用的抗抑郁药(32.0%),平均日剂量为 24.1(SD,8.1)mg。在该样本中,为了控制攻击和激越,两种或更多的药物经常联合使用。苯二氮䓬类药物并不常用。

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