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老年患者中传统抗精神病药物与新型抗精神病药物的比较

Conventional vs. newer antipsychotics in elderly patients.

作者信息

Jeste D V, Rockwell E, Harris M J, Lohr J B, Lacro J

机构信息

Department of Psychiatry, University of California, San Diego, USA.

出版信息

Am J Geriatr Psychiatry. 1999 Winter;7(1):70-6.

PMID:9919323
Abstract

Elderly patients with schizophrenia and dementia patients with agitation are frequently candidates for antipsychotic treatment. Conventional neuroleptics have relatively little effect on negative symptoms and may cause considerable side effects, especially in elderly patients. The authors have found a 29% cumulative annual incidence of tardive dyskinesia (TD) in middle-aged and elderly outpatients treated with relatively low doses of conventional neuroleptics Newer antipsychotics are less likely to cause extrapyramidal symptoms and may be associated with a lower risk of TD. They are generally effective for both positive and negative symptoms and may also improve some aspects of cognition, but these drugs have their own side effects. Dosing requirements for elderly patients tend to be much lower than those for younger adults.

摘要

患有精神分裂症的老年患者以及伴有激越症状的痴呆患者常常是抗精神病药物治疗的适用对象。传统抗精神病药物对阴性症状的疗效相对较差,并且可能引发相当多的副作用,尤其是在老年患者中。作者发现,接受相对低剂量传统抗精神病药物治疗的中老年门诊患者中,迟发性运动障碍(TD)的年累积发病率为29%。新型抗精神病药物引发锥体外系症状的可能性较小,且可能与较低的TD风险相关。它们通常对阳性和阴性症状均有效,还可能改善认知的某些方面,但这些药物也有自身的副作用。老年患者的给药剂量往往比年轻成年人低得多。

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