痴呆患者癫痫的药物治疗:一个系统的回顾

Title:Pharmacological Medical Treatment of Epilepsy in Patients with Dementia: A Systematic Review

Volume: 18 Issue: 9

关键词: 老年痴呆症，阿尔茨海默氏症，癫痫，抗癫痫药物，左乙拉西坦，老年人。

摘要:

Background: Patients with dementia have an increased risk of developing epilepsy, especially in patients with vascular dementia and Alzheimer’s disease. In selecting the optimal anti- epileptic drug (AED), the possible side effects such as drowsiness and worsening of cognitive function should be taken into consideration, together with co-morbidities and type of epilepsy.

Objective: The current systematic review investigates the efficacy, tolerability, and changes in cognitive function after administration of AED in patients with dementia and epilepsy.

Methods: We searched six databases, including MEDLINE and CENTRAL, checked reference lists, contacted experts, and searched Google Scholar to identify studies reporting randomized trials. Studies identified were independently screened, data extracted, and quality appraised by two researchers. A narrative synthesis was used to report findings.

Results: We included one study with 95 patients with Alzheimer’s disease randomized to either levetiracetam, lamotrigine, or phenobarbital. No significant differences were found for efficacy, but patients receiving levetiracetam showed an improvement in mini-mental state examination scores and had fewer adverse events.

Conclusion: High-quality evidence in the form of randomized controlled trials to guide clinicians in choosing an AED in patients with dementia and concomitant epilepsy remains scarce. However, levetiracetam has previously been shown to possibly improve cognition in patients with both mild cognitive impairment and Alzheimer’s disease, is better tolerated in the elderly population, and has no clinically relevant interaction with either cholinesterase inhibitors or NMDA receptor antagonists.

Cite this article as:

Pharmacological Medical Treatment of Epilepsy in Patients with Dementia: A Systematic Review, Current Alzheimer Research 2021; 18 (9) . https://dx.doi.org/10.2174/1567205018666211126121529