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Pharmacological treatment of psychosis and agitation in elderly patients with dementia: four decades of experience.

机译：老年痴呆症患者的精神病和躁动的药理治疗：四十年的经验。

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A number of studies, using different research designs and assessment instruments, have been conducted to elucidate the differential effects of drug treatments for psychosis, agitation and aggression in elderly patients with dementia. We have reviewed literature published from 1960 to 2000 on this topic; 48 studies that met our selection criteria were identified from Medline and Science Citation Index. Antipsychotic medication was generally effective for the treatment of psychosis and agitation in elderly patients with dementia. In double-blind, placebo-controlled trials in this population, mean improvement rates were 61% with antipsychotics and 35% with placebo. Atypical antipsychotics appeared promising, but the number of well-designed studies has been small so far. Methodological limitations of the studies reviewed are discussed; future trials should ensure adequate sample size and duration and involve direct comparisons of individual medications. In conclusion, conventional antipsychotics are modestly effective for treatment of psychosis and agitation in elderly individuals with dementia, whereas newer treatments such as atypical antipsychotics appear to be at least as effective while having fewer adverse effects. Nonetheless, there is no currently available ideal pharmacotherapy, and psychosocial management is a necessary part of overall treatment. Additional large-scale, well-controlled studies are needed before conclusive statements regarding the value of treatment of psychosis and agitation with atypical antipsychotics and non-antipsychotic agents can be made.
机译：已经使用不同的研究设计和评估工具进行了许多研究，以阐明药物治疗对老年痴呆患者的精神病，躁动和攻击性的不同作用。我们回顾了1960年至2000年有关该主题的文献。从Medline和《科学引文索引》中鉴定了48项符合我们选择标准的研究。抗精神病药通常可有效治疗老年痴呆症患者的精神病和躁动。在该人群的双盲，安慰剂对照试验中，抗精神病药物的平均改善率为61％，安慰剂的平均改善率为35％。非典型抗精神病药似乎很有希望，但到目前为止，精心设计的研究数量很少。讨论了所审查研究的方法学局限性;未来的试验应确保有足够的样本量和持续时间，并应直接比较各个药物。总之，常规抗精神病药对老年痴呆症患者的精神病和躁动有中等程度的治疗效果，而诸如非典型抗精神病药等较新的治疗方法似乎至少具有同样的效果，同时副作用较少。然而，目前尚无理想的药物疗法，心理社会管理是整体治疗的必要组成部分。在做出关于使用非典型抗精神病药和非抗精神病药治疗精神病和躁动的价值的结论性陈述之前，还需要进行其他大规模的，控制良好的研究。

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