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锡塔洛普拉姆对阿尔茨海默病激发的作用:CitAD随机临床试验
Anton P Porsteinsson1, Lea T Drye2, Bruce G Pollock3
1University of Rochester School of Medicine and Dentistry, Rochester, New York.
JAMA
|February 20, 2014
概括
在阿尔茨海默氏症患者中,西塔洛普拉姆显著降低了焦虑和护理人员的痛苦. 然而,认知和心脏的副作用可能会将其使用限制在每天30毫克.
科学领域:
- 老年医学 老年医学
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 兴奋是阿尔茨海默病 (AD) 患者常见和持续的症状,往往导致不良结果.
- 目前的药物治疗方法,包括抗精神病药物,对于对阿尔茨海默病患者的激动症进行管理并不完全令人满意.
研究的目的:
- 评估citalopram在降低阿尔茨海默氏症患者兴奋的疗效.
- 评估citalopram对患者功能,护理人员痛苦,安全,认知功能和耐受性的影响.
主要方法:
- 一个随机的,安慰剂控制的,双盲试验 (阿尔茨海默病研究中兴奋的Citalopram - CitAD) 涉及186名可能患有阿尔茨海默病和显著兴奋的患者.
- 参与者接受了心理社会干预,再加上9周的西塔洛普拉姆 (高达30毫克/天) 或安慰剂.
- 通过神经行为评分表激动子表 (NBRS-A) 和修改的阿尔茨海默病合作研究-临床全球变化印象 (mADCS-CGIC) 测量的主要结果.
主要成果:
- 与安慰剂相比,在NBRS-A (P=.04) 和mADCS-CGIC (P=.01) 两种测试中,西塔洛普拉姆显著改善了激发得分.
- 在科恩 - 曼斯菲尔德兴奋清单 (CMAI),神经精神病学清单 (NPI) 总分和护理人员痛苦中也观察到改善.
- 认知恶化 (P=.03) 和 QT 间隔延长 (P=.01) 在西塔洛普拉姆组中被观察到.
结论:
- 当添加到心理社会干预时,西塔洛普拉姆有效地减少了阿尔茨海默病患者的焦虑和护理人员的痛苦.
- 30毫克/天的潜在认知和心脏不良影响可能会限制其临床适用性.
- 进一步的研究可能会探索最佳的剂量或替代策略来管理AD的激动.
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