Semla T P, Cohen D, Freels S, Paveza G J, Ashford J W, Gorelick P, Luchins D, Eisdorfer C
College of Pharmacy, University of Illinois at Chicago 60612, USA.
Pharmacotherapy. 1995 Jul-Aug;15(4):495-501.
We attempted to determine the relationship between psychiatric symptoms and psychotropic drug use in persons with Alzheimer's disease based on a multicenter patient registry of 671 community-living persons diagnosed with the disease by published criteria. Logistic regression was performed to determine which symptoms were associated psychotropic use after controlling for age, sex, and Mini-Mental Status Examination (MMSE) score. At least one psychotropic drug was reported by 31% of patients, and 66% had at least one psychiatric symptom. Antipsychotics were associated with a lower MMSE score (odds ratio = 0.92, 95% confidence interval 0.88-0.97), emotional lability (OR = 4.52, 95% CI 1.69-11.94), and hallucinations (OR = 6.54, 95% CI 2.99-14.26). Antidepressants were associated with depressive symptoms (OR = 5.8, 95% CI 2.61-13.46), and benzodiazepines with a lower MMSE score (OR = 0.93, 95% CI 0.90-0.97). Community-living persons with Alzheimer's disease are frequently prescribed psychotropic drugs; however, more than 50% of patients with a psychiatric symptom did not report taking one of these agents. This suggests that alternative therapies and no treatment are also prevalent.
我们试图基于一个多中心患者登记库，确定阿尔茨海默病患者精神症状与精神药物使用之间的关系，该登记库纳入了671名根据已发表标准诊断为该病的社区居住患者。进行逻辑回归分析，以确定在控制年龄、性别和简易精神状态检查表（MMSE）评分后，哪些症状与精神药物使用相关。31%的患者报告至少使用了一种精神药物，66%的患者至少有一种精神症状。抗精神病药物与较低的MMSE评分（比值比=0.92，95%置信区间0.88 - 0.97）、情绪不稳定（比值比=4.52，95%置信区间1.69 - 11.94）和幻觉（比值比=6.54，95%置信区间2.99 - 14.26）相关。抗抑郁药物与抑郁症状相关（比值比=5.8，95%置信区间2.61 - 13.46），苯二氮䓬类药物与较低的MMSE评分相关（比值比=0.93，95%置信区间0.90 - 0.97）。社区居住的阿尔茨海默病患者经常被开具精神药物；然而，超过50%有精神症状的患者未报告使用这些药物中的任何一种。这表明替代疗法和不进行治疗的情况也很普遍。
