Robles A, Rodríguez Navarrete F J, Taboada O, Docasar L, Páramo M, Noya M
Servicio de Neurologia, Hospital General de Galicia, Santiago de Compostela.
Rev Neurol. 1996 Mar;24(127):273-5.
Persistent psychomotor agitation and psychotic ideation in patients with Alzheimer's disease are normally treated orally with antipsychotic drugs and are occasionally treated with other drugs. Neuroleptics administered intramuscularly at very low doses are an alternative, especially when the patient rejects medicine as a results of his or her anosognosia or of paranoid manifestations. We present the results we obtained after observing the effects of depot zuclopenthixol in six patients with probable Alzheimer's disease (based upon NINCDS-ADRDA criteria). Psychic abnormalities were assessed as per the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS). Possible extrapyramidal side effects were evaluated by means of the Abnormal Involuntary Movement Scale (AIMS). Initially 60 mg (0.3 ml) were administered intramuscularly and successive doses could be modified by +/-20 mg (0.1 ml) according to results seen on the various scales. During the first six weeks of treatment progressive improvement was noted on all three psychic functions scales in all patients. Between the sixth and twelfth weeks improvement continued although without significant change. The AIMS did not show significant changes in the twelve weeks of follow-up. We consider depot zuclopenthixol at low doses as efficacious in treating persistent psychomotor agitation and/or psychotic manifestations of Alzheimer's disease. No undesired side effects were observed in our group after a twelve week follow-up.
阿尔茨海默病患者的持续性精神运动性激越和精神病性观念通常采用抗精神病药物口服治疗,偶尔也会使用其他药物。极低剂量肌肉注射的抗精神病药物是一种替代方法,特别是当患者由于疾病感缺失或偏执表现而拒绝服药时。我们展示了观察长效珠氯噻醇对6例可能患有阿尔茨海默病患者(基于NINCDS-ADRDA标准)的疗效后所获得的结果。根据简明精神病评定量表(BPRS)、阳性症状评定量表(SAPS)和阴性症状评定量表(SANS)对精神异常进行评估。通过异常不自主运动量表(AIMS)评估可能的锥体外系副作用。最初肌肉注射60毫克(0.3毫升),后续剂量可根据各量表的结果以±20毫克(0.1毫升)进行调整。在治疗的前六周,所有患者的三项精神功能量表均显示出逐渐改善。在第六周和第十二周之间,改善仍在持续,尽管没有显著变化。在为期十二周的随访中,AIMS未显示出显著变化。我们认为低剂量的长效珠氯噻醇在治疗阿尔茨海默病的持续性精神运动性激越和/或精神病性表现方面是有效的。在我们的研究组中,经过十二周的随访未观察到不良副作用。