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パーキンソン病の薬理学的治療:レビュー
Barbara S Connolly1, Anthony E Lang2
1Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
JAMA
|April 24, 2014
まとめ
パーキンソン病の管理は,症状緩和に焦点を当て,レボドーパとドーパミンアゴニストが運動症状の鍵となる. 非運動症状と薬剤の副作用は,それに合わせた薬理学的戦略を必要とします.
科学分野:
- 神経学 神経学とは
- 薬理学 薬理学とは
背景:
- パーキンソン病は,一般的な神経退行性障害です.
- 現在の治療法は,疾患の進行ではなく,症状を管理しています.
- 効果的な症状治療は,患者の生活の質を向上させます.
研究 の 目的:
- パーキンソン病の運動症状の初期薬理学的管理をレビューする.
- 運動合併症と薬物の副作用の管理について説明する.
- 非運動症状の管理について議論します.
主な方法:
- パブメドとコクラン図書館 (1985年−2014年) の体系的な文献検索.
- 英語の人類研究. 英語の人類研究.
- 研究の質は,アメリカ神経科学アカデミーのガイドラインを使用して評価されました.
主要な成果:
- レボドーパは,運動症状に非常に効果的です.
- レボドーパの合併症を遅らせるために,当初は代替薬を使用することがあります.
- レボドーパの調整または他の薬物の添加によって制御される運動の変動.
- ドーパミン作用薬の投与量を減らすことによって管理される衝動制御障害.
- 非運動症状の管理に関する証拠は限られている.
結論:
- レボドーパとドーパミンアゴニストは,運動症状に対して強く支持されています.
- ドーパミンアゴニストとドーパミン代謝阻害剤は,運動の変動を助けます.
- クロザピンは幻覚に対して有効であり,ホリネステラゼ阻害剤は認知症に対して有効である.
- 抗うつ剤とプラミペクソールは,うつ病に役立つ可能性があります.
- 他の治療法に関する証拠は,それほど確立されていない.
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