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Titolo:
Behavioural problems associated with dementia - The role of newer antipsychotics
Autore:
Stoppe, G; Brandt, CA; Staedt, JH;
Indirizzi:
Univ Gottingen, Dept Psychiat, D-37075 Gottingen, Germany Univ Gottingen Gottingen Germany D-37075 iat, D-37075 Gottingen, Germany
Titolo Testata:
DRUGS & AGING
fascicolo: 1, volume: 14, anno: 1999,
pagine: 41 - 54
SICI:
1170-229X(199901)14:1<41:BPAWD->2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
NURSING-HOME PATIENTS; LEWY BODY DEMENTIA; SANDOZ CLINICAL ASSESSMENT; ORGANIC BRAIN DISEASE; PSYCHOTROPIC-DRUG USE; SPECIAL CARE UNITS; ALZHEIMERS-DISEASE; SENILE DEMENTIA; DOUBLE-BLIND; PARKINSONS-DISEASE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
165
Recensione:
Indirizzi per estratti:
Indirizzo: Stoppe, G UnivyGottingen, Dept Psychiat, Von Siebold Str 5, D-37075 Gottingen, German Univ Gottingen Von Siebold Str 5 Gottingen Germany D-37075 rman
Citazione:
G. Stoppe et al., "Behavioural problems associated with dementia - The role of newer antipsychotics", DRUG AGING, 14(1), 1999, pp. 41-54

Abstract

Behavioural disorders are a common feature in dementia, especially in the later stages of the disease. The most frequent disorders are agitation, aggression, paranoid delusions, hallucinations, sleep disorders, including nocturnal wandering, incontinence and (stereotyped) vocalisations or screaming. Behavioural disorders, rather than cognitive disorders, are the main reason why caregivers place patients with dementia in a nursing home. However, although behavioural disorders are important, there is still no international agreement with respect to the description and definition of symptoms andsyndromes. This also holds true for the wide variety of scales for quantification and measurement of behavioural disorders. Drug therapy should be considered after possible underlying causes such asphysical illness, drug adverse effects and environmental stressors have been ruled out, or specifically addressed, and a behavioural approach has also failed. This article briefly reviews the evidence for non-antipsychotic drug therapies, which include a variety of substances. However, antipsychotics are the group of drugs which have been most frequently studied for the treatment of behavioural syndromes in dementia. Drug responsive symptoms include anxiety, Verbal and physical agitation, hallucinations, delusions, uncooperativeness and hostility, whereas wandering, hoarding, unsociability, poor self-care, screaming and other stereotyped behaviour seem to be unresponsive to all drugs. Although the use of classical antipsychotics is limited by extrapyramidal symptoms, anticholinergic adverse effects, sedation and postural hypotension, the newer antipsychotics offer the chance of a better risk:benefit ratio. This article reviews the small amount of data published on the use of thenewer antipsychotics, and concludes that risperidone at low dosages (0.5 to 2 mg/day) seems to be especially useful for the treatment of behavioural symptoms in dementia because of its negligible anticholinergic adverse effects. The use of clozapine is limited by its anticholinergic activity, at least in dementia of the Alzheimer and Lewy body types. However, in patients with psychosis arising from Parkinson's disease it seems to be the drug of choice, and similar activity is likely for olanzapine. There are no published data on other newer drugs, such as sertindole, quetiapine or ziprasidone. Future studies should also address questions of dementia heterogeneity andshould compare different drug treatments and treatment combinations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 11:52:50