痴呆的行为和精神症状的药物治疗调查

目的：了解抗精神病药治疗痴呆的行为和精神症状（BPSD）的情况。方法：调查443例伴有明显的行为和精神症状、用抗精神病药治疗其行为和精神症状有效的阿尔茨海默病和血管性痴呆患者。结果：常用于治疗BPSD的抗精神病药有奋乃静、利培酮、氟哌啶醇、氯丙嗪、氯氮平、硫利达嗪、舒必利等，其起始剂量与有效剂量均较小，大多单一用药。用药剂量与年龄呈负相关。主要不良反应是锥体外系反应、便秘或排尿困难、嗜睡或步态不稳、吞咽困难等。抗精神病药不良反应发生率为16．0％，典型抗精神病药发生率（18．4％）显著高于非典型抗精神病药（9．6％）。结论：多种抗精神病药治疗BPSD均有效，治疗剂量低。非典型抗精神病药的安全性优于典型抗精神病药。

Investigation of antipsychotic drugs used in behavioral and psychological symptoms of dementia

Objective:To know the applied character and adverse drug reactions of antipsychotic drugs used in behavioral and psychological symptoms of dementia(BPSD). Method:We investigated 443 Alzheimer disease(AD) and vascular disease(VD) patients,with significant behavioral and psychological symptoms,effectually treated by antipsychotic drugs. Results:BPSD was commonly treated by perphenazine,risperidone,haloperidol,chlorpromazine,clozapine,thioridazine,sulpiride,et al.The initial and therapeutic dosages were small.Most of the patients were treated by one antipsychotic drug.The therapeutic dosage was related to age negatively.The main adverse drug reactions were extrapyramidal side effect,constipation,dysuria,hypersomnia,gait instability,dysphagia,et al.The total rate of adverse drug reactions of antipsychotic drugs was 16.0%,the incidence of typical antipsychotic drugs(18.4%) was higher than that of atypical antipsychotic drugs(9.6%). Conclusion:Many antipsychotic drugs could treat BPSD effectually,and the therapeutic dosage is lower.The safety of atypical antipsychotic drugs is better than typical antipsychotic drugs.