Shankle W R, Nielson K A, Cotman C W
Department of Neurology, University of California-Irvine, U.S.A.
Alzheimer Dis Assoc Disord. 1995 Winter;9(4):233-7.
Although several reports suggest that intermediate to high doses of propranolol (80-160 and 200-600 mg/day) can effectively treat aggressive behavior in dementia, significant side effects can occur at these doses. To minimize these side effects, we treated and followed-up a series of 12 demented patients, whose caregivers sought medical help for their disruptive, aggressive behavior, with low-dose propranolol monotherapy (10-80 mg/day). Assessment measures obtained at baseline and during treatment by caregiver interview included ordinal ratings of aggression severity, the Cohen-Mansfield Agitation Inventory (CMAI), and the California Behavior Questionnaire (CBQ). The aggression ratings showed that low-dose propranolol effectively reduced aggression in eight of 12 patients (67%) within 2 weeks of treatment and remained effective for the duration of follow-up (1 to 14 months). Subscales of the CMAI showed responders to have significant reductions in physical and verbal aggression/agitation and in pacing/wandering. These results suggest that low-dose propranolol should be further studied for treating aggression or agitation in demented patients.
尽管有几份报告表明，中高剂量的普萘洛尔（80 - 160毫克/天和200 - 600毫克/天）可有效治疗痴呆患者的攻击行为，但这些剂量可能会产生显著的副作用。为了尽量减少这些副作用，我们对一系列12名痴呆患者进行了治疗和随访，这些患者的照料者因其具有破坏性行为和攻击行为而寻求医疗帮助，我们采用低剂量普萘洛尔单一疗法（10 - 80毫克/天）对他们进行治疗。通过照料者访谈在基线和治疗期间获得的评估指标包括攻击严重程度的序贯评分、科恩 - 曼斯菲尔德激越量表（CMAI）和加利福尼亚行为问卷（CBQ）。攻击评分显示，低剂量普萘洛尔在治疗2周内有效降低了12名患者中8名（67%）的攻击行为，并且在随访期间（1至14个月）一直有效。CMAI的分量表显示，有反应者在身体和言语攻击/激越以及踱步/徘徊方面有显著减少。这些结果表明，低剂量普萘洛尔在治疗痴呆患者的攻击行为或激越方面应进一步研究。
