痴呆症临床实践指南:对行为和心理症状的药理治疗的建议
Gihwan Byeon1, Dong Woo Kang1, Yeshin Kim2
1Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Dementia and neurocognitive disorders
|February 13, 2025
概括
这项研究提供了基于证据的指导方针,用于使用抗精神病药物和抗抑郁药物等药物来管理痴呆症 (BPSD) 的行为和心理症状. 建议侧重于个性化治疗,以改善患者和护理人员的福祉.
科学领域:
- 老年学是指老年学的学科.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 痴呆症的行为和心理症状 (BPSD) 显著损害生活质量,增加护理人员的负担.
- 有效的药理管理BPSD对于患者和护理人员的福祉至关重要.
研究的目的:
- 建立基于证据的临床实践指南,用于痴呆症中BPSD的药理治疗.
- 提供关于使用抗精神病药物,抗抑郁药,认知增强剂和其他治疗BPSD的药物的建议.
主要方法:
- 由韩国痴呆症协会质量管理委员会制定的指导方针.
- 系统的文献搜索和随机对照试验的质量评估.
- 建议使用推,评估,发展和评价 (GRADE) 系统进行分级.
主要成果:
- 对抗精神病药物 (如瑞斯佩里) 的条件建议,用于攻击性和精神病.
- 抗抑郁药物 (例如,citalopram) 建议用于阿尔茨海默氏症的激动.
- 认知增强剂对一般的BPSD和REM睡眠行为障碍表现出适度的疗效;皮马万塞林对阿尔茨海默病的精神病有效.
结论:
- 该指南提供了一种结构化的BPSD药理管理方法,考虑有效性和安全性.
- 强调个性化治疗计划,以优化结果并最大限度地降低风险.
- 对于证据有限的治疗方法,建议采用有条件的方法.
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