摘要
焦虑和攻击性行为是阿尔茨海默病的常见精神症状,在痴呆症患者是非常普遍的。当有必要药物干预时,目前的临床实践指南推荐抗精神病药物、胆碱酯酶抑制剂和某些抗抑郁药。然而,这些干预措施呈中到低的有效性,那些呈现最好疗效的药物有着显著的安全性问题。因此,目前的研究主要集中在新的化合物不同的作用机制,并可能更好的平衡其有效性和安全性。这篇评论的目的是评估治疗AD患者的焦虑和攻击性行为新的药物疗法的应用管理。我们进行了全面的文献检索来确定最近的治疗AD焦虑和攻击性行为,没有收纳在大多数的临床实践指南里或目前正在进行临床试验中的新型药物。综述表明,新型的疗法如大麻类、锂、非甾体类抗炎药、镇痛药、麻醉药、和更新的抗癫痫药物,可能为治疗AD焦虑和攻击性行为提供更安全的替代治疗方案,还需要进一步的研究来阐明其风险和收益。
关键词: 焦虑、攻击、阿尔茨海默病、镇痛药、抗炎药、大麻、锂、麻醉剂。
Current Alzheimer Research
Title:Pharmacological Management of Agitation and Aggression in Alzheimer’s Disease: A Review of Current and Novel Treatments
Volume: 13 Issue: 10
Author(s): Celina S. Liu, Myuri Ruthirakuhan, Sarah A. Chau, Nathan Herrmann, André F. Carvalho, Krista L. Lanctôt
Affiliation:
关键词: 焦虑、攻击、阿尔茨海默病、镇痛药、抗炎药、大麻、锂、麻醉剂。
摘要: Agitation and aggression are common neuropsychiatric symptoms of Alzheimer’s disease and are highly prevalent in people with dementia. When pharmacological intervention becomes necessary, current clinical practice guidelines recommend antipsychotics, cholinesterase inhibitors, and some antidepressants. However, those interventions have modest to low efficacy, and those with the highest demonstrated efficacy have significant safety concerns. As a result, current research is focusing on novel compounds that have different mechanisms of action and that may have a better balance of efficacy over safety. The purpose of this review is to evaluate novel pharmacological therapies for the management of agitation and aggression in AD patients. We performed a comprehensive literature search to identify recent novel drugs that are not included in most clinical practice guidelines or are currently undergoing clinical trials for the treatment of agitation and/or aggression in AD. This review suggests that novel treatments, such as cannabinoids, lithium, non-steroidal anti-inflammatory drugs, analgesics, narcotics, and newer antiepileptic drugs, may provide a safer alternative treatment option for the management of agitation and aggression in AD and requires further study in order to clarify their risks and benefits.
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Celina S. Liu, Myuri Ruthirakuhan, Sarah A. Chau, Nathan Herrmann, André F. Carvalho, Krista L. Lanctôt , Pharmacological Management of Agitation and Aggression in Alzheimer’s Disease: A Review of Current and Novel Treatments, Current Alzheimer Research 2016; 13 (10) . https://dx.doi.org/10.2174/1567205013666160502122933
DOI https://dx.doi.org/10.2174/1567205013666160502122933 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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