Schneider L S
Department of Psychiatry and the Behavioral Sciences, School of Medicine, University of Southern California, Los Angeles 90033, USA.
J Clin Psychiatry. 1998;59 Suppl 11:8-13.
Therapeutic approaches to the cognitive impairment of dementia are making their way into clinical practice. Clinical pharmacologic approaches toward improvement of cognitive symptoms are discussed, with an emphasis on cholinergic approaches, since they currently appear most promising and since several cholinesterase inhibitors may soon be available for prescribing. As more knowledge is gained about dosing, side effects, and mechanisms of action, these drugs can be prescribed more efficiently. Current research approaches to slowing the rate of cognitive decline are discussed, including the use of antioxidants, monoamine oxidase-B inhibitors, and cholinesterase inhibitors. Drugs that improve cognition may also have effects on behavioral symptoms, severe dementia, and non-Alzheimer's dementia. Evidence suggests that some dementia patients may be particularly responsive to intervention and that other medications may enhance response. Psychosocial interventions may also contribute to prolonging the time to institutionalization.
针对痴呆症认知障碍的治疗方法正在进入临床实践。本文讨论了改善认知症状的临床药理学方法，重点是胆碱能方法，因为它们目前看起来最有前景，而且几种胆碱酯酶抑制剂可能很快就可供处方使用。随着我们对剂量、副作用和作用机制有了更多了解，这些药物可以更有效地开具处方。本文还讨论了目前减缓认知衰退速度的研究方法，包括使用抗氧化剂、单胺氧化酶-B抑制剂和胆碱酯酶抑制剂。改善认知的药物也可能对行为症状、重度痴呆和非阿尔茨海默病性痴呆有影响。有证据表明，一些痴呆症患者可能对干预特别敏感，而其他药物可能会增强这种反应。心理社会干预也可能有助于延长送入养老院的时间。
