利醅酮改善痴呆患者心理及行为症状的特点

The characteristic of risperidone in ameliorating the psychological and behavioral symptoms of patients with dementia

目的:评价利醅酮治疗痴呆患者心理和行为症状psychologicalandbe-(havioralsymptomsofdementia,BPSD)疗效与安全性。方法:应用利醅酮治疗南京医科大学脑科医院老年精神科阿尔茨海默病(Alzheimerdisease,AD)(n=25)、混合性痴呆(mixeddementia,MD)(n=22)、血管性痴呆(vasculardementia,VD)(n=19),1.5mg/d,治疗6周。于治疗前后采用AD行为症状评定量表(BEHAVE-AD、Co-)hen-Masfield激惹性问卷CMAI)评定痴呆患者BPSD,采用副反应量表((TE)SS评价副反应。结果:利醅酮治疗后痴呆患者的偏执与妄想观念(65%)、幻觉(2/3)、攻击行为的发生率(38%)显著低于治疗前,差异有显著性(χ2=5.41,227.39,61.88;P均<0.05);治疗后攻击行为(32%)、语言攻击(30%)及总的激惹的发生率64%明显下降,与治疗前比较,差异有显()著性(χ2=40.22,52.30,31.69;P均<0.05)。利醅酮治疗后痴呆患者的偏执与妄想观念、幻觉、行为紊乱,攻击行为、日夜节律紊乱,焦虑与恐惧的严重程度较治疗前明显减轻,差异有显著性t=3.00～11.46,P(均<0.05);治疗后痴呆患者的总的激惹、攻击行为、语言攻击、乱走、无目的游荡,试图出走的严重程度明显减轻,与治疗前比较,差异有显著性t=3.45～8.79,P<0.05)。利醅酮治疗的副作用主要为轻度嗜(睡,肌强直,震颤(10/66)。

AIM:To assess the efficacy and safety of risperidone for treating psychological and behavioral symptoms of dementia(BPSD). <METHODS:Totally 66 patients with dementia selected from the Department of Aging Psychiatry of Brain Hospital,Nanjing Medical University,were received risperidone (1.5 mg per day) for 6 weeks.There were 25 cases for Alzheimer disease(AD),22 cases for mixed dementia(MD) and 19 cases for vascular dementia(VD).BPSD were assessed by the Behavioral Pathology in Alzheimer's Disease Rating Scale(BEHAVE AD),the Cohen Mansfield Agitation Inventory(CMAI).The adverse events were assessed by the Treatment Emergent Symptom Scales(TESS).<RESULTS: After treated with risperidone, the incidence of crankiness and delusion(65% ) ,hallucination(2/3) and aggressive behavior(38% ) in patients with dementia were lower than pretherapy.There was significant difference( χ 2=5.41,227.39,61.88 P< 0.05) . Post treatments, the incidence of aggressive behavior (32% ), linguistic aggression(30% ) and total agitation(64% ) reduced significantly.There was significant difference before and after treatment ( χ 2=40.22,52.30,31.69;P< 0.05) .After treated with risperidone,the severity of crankiness and delusion,hallucination,behavioral disturbance,aggressive behavior,day and night reversal,anxiety and dread relieved obviously.There was significant difference( t =3.00- 11.46,P< 0.05) . The severity of total agitation,aggressive behavior,linguistic aggression, random walking, aimless debauchery and trying to elopement relieved obviously.There was significant difference( t=3.45 to 8.79,P< 0.05) .The mainly ill effects of risperidone were slight drowsiness,myotonus and tremor (10/66).<CONCLUSION: Isperidone is effective and safe in the treatment of BPSD and the ill effects are slight.