...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The journal of clinical psychiatry >Lewy body dementia: the litmus test for neuroleptic sensitivity and extrapyramidal symptoms.
【24h】

Lewy body dementia: the litmus test for neuroleptic sensitivity and extrapyramidal symptoms.

机译：路易体痴呆：石蕊试纸用于精神安定药敏感性和锥体束外症状。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Lewy body dementia, also referred to as dementia with Lewy bodies (DLB), is a neurodegenerative disorder now considered to be the second most common cause of dementia after Alzheimer's disease. Postmortem findings suggest that DLB accounts for 20% to 34% of all dementia cases and is often underdiagnosed. Salient features of DLB include fluctuations in cognition, perceptual abnormalities (e.g., visual hallucinations), and mild parkinsonism. Other symptoms include frequent falls, nighttime agitation, and depression. DLB symptomatology can be partly explained by the extensive destruction of dopaminergic and acetylcholinergic pathways caused by neurodegeneration. For this reason, DLB patients are especially vulnerable to the antidopaminergic and anticholinergic actions of most conventional antipsychotics, which makes treatment of the psychotic symptoms of DLB extremely difficult. Patients are particularly sensitive to developing extrapyramidal symptoms (EPS) and also to the potentially fatal complication of neuroleptic sensitivity, which affects approximately 50% of DLB patients. Therefore, a need exists for antipsychotic drugs with less propensity to induce EPS and reduced affinity for dopamine and acetylcholine receptors. Here we review studies evaluating the efficacy and tolerability of atypical antipsychotics for the treatment of psychoses associated with DLB. Olanzapine appears to be poorly tolerated, and risperidone has been associated with high risk of neuroleptic malignant syndrome. Clozapine use remains controversial because of its potent anticholinergic action and risk of agranulocytosis. Quetiapine has been shown to reduce psychiatric manifestations of DLB without causing neuroleptic sensitivity or increasing EPS. Hence, quetiapine is an attractive candidate for the treatment of psychoses in DLB and other dementias.
机译：路易氏体痴呆症，也称为路易氏体痴呆症（DLB），是一种神经退行性疾病，目前被认为是继阿尔茨海默氏病之后第二大最常见的痴呆病因。验尸结果表明，DLB占所有痴呆病例的20％至34％，并且常常被误诊。 DLB的主要特征包括认知波动，知觉异常（例如视觉幻觉）和轻度帕金森症。其他症状包括频繁跌倒，夜间躁动和抑郁。 DLB症状可以部分解释为神经变性引起的多巴胺能和乙酰胆碱能途径的广泛破坏。因此，DLB患者特别容易受到大多数常规抗精神病药的抗多巴胺能和抗胆碱能的作用，这使得治疗DLB的精神病症状极为困难。患者对出现锥体束外症状（EPS）尤其敏感，对神经安定药敏感性的潜在致命并发症特别敏感，这种疾病影响约50％的DLB患者。因此，需要抗精神病药诱导EPS的倾向和对多巴胺和乙酰胆碱受体的亲和力降低。在这里，我们审查评估非典型抗精神病药治疗与DLB相关的精神病的疗效和耐受性的研究。奥氮平似乎耐受性差，利培酮与神经安定性恶性综合症的高风险有关。氯氮平的使用仍存在争议，因为其有效的抗胆碱能作用和粒细胞缺乏症的风险。喹硫平已被证明可以减少DLB的精神症状，而不会引起精神安定药敏感性或增加EPS。因此，喹硫平是用于治疗DLB和其他痴呆中的精神病的有吸引力的候选人。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号