치매의 약물치료
Pharmacological Treatment of Dementia
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초록
Pharmacological interventions are critical in dementia treatment to prevent disease progression. In this review, we aim to summarize and discuss about the current developments and recommendations in the pharmacological treatment of dementia. Cholinesterase inhibitors have demonstrated efficacy for Alzheimer’s disease, mixed pathology with vascular dementia and Parkinson’s disease dementia. The comparison study revealed no difference between each cholinesterase inhibitors. A high incidence of side effects of cholinesterase inhibitors could lower compliance. In this case, changing to the other drug or trying a transdermal type could be the solution. Memantine, a N-methyl-D-aspartate receptor antagonist, has proven to improve function at moderate to severe dementia and for dementia with Lewy body. But there are still in- sufficient evidences for the combination of a cholinesterase inhibitors and memantine. Discontinuing medicine in moderate to severe dementia may lead to worsening of cognitive function. For this reason, improving patients’ compliance is im- portant and for drug selection we should consider the type of dementia, severity of cognitive impairment and side effects of each medicine. Noncognitive symptoms, behavioral and psychological symptoms of dementia (BPSD) are common and can dominate disease presentation. For depression, selective serotonin reuptake inhibitors could be effective. Atypical antipsychotics could be used for other neuropsychological symptoms such as agitation, aggression, delusions and hallucinations.
Abstract
Pharmacological interventions are critical in dementia treatment to prevent disease progression. In this review, we aim to summarize and discuss about the current developments and recommendations in the pharmacological treatment of dementia. Cholinesterase inhibitors have demonstrated efficacy for Alzheimer’s disease, mixed pathology with vascular dementia and Parkinson’s disease dementia. The comparison study revealed no difference between each cholinesterase inhibitors. A high incidence of side effects of cholinesterase inhibitors could lower compliance. In this case, changing to the other drug or trying a transdermal type could be the solution. Memantine, a N-methyl-D-aspartate receptor antagonist, has proven to improve function at moderate to severe dementia and for dementia with Lewy body. But there are still in- sufficient evidences for the combination of a cholinesterase inhibitors and memantine. Discontinuing medicine in moderate to severe dementia may lead to worsening of cognitive function. For this reason, improving patients’ compliance is im- portant and for drug selection we should consider the type of dementia, severity of cognitive impairment and side effects of each medicine. Noncognitive symptoms, behavioral and psychological symptoms of dementia (BPSD) are common and can dominate disease presentation. For depression, selective serotonin reuptake inhibitors could be effective. Atypical antipsychotics could be used for other neuropsychological symptoms such as agitation, aggression, delusions and hallucinations.
참고문헌 (23)
- Cummings JL, "High-dose donepezil (23 mg", day) for the treatment of moderate and severe alzheimer's disease: Drug profile and clinical guidelines, 2013, pp.19, 294~301
- Lefevre G, "Pharmacokinetics and pharmacodynamics of the novel daily rivastigmine transdermal patch compared with twice-daily capsules in alzheimer's disease patients", Clin Pharmacol Ther, 83, pp.106~114 (2008)
- Herrmann N, "Pharmacological recommendations for the symptomatic treatment of dementia: The canadian consensus conference on the diagnosis and treatment of dementia 2012", Alzheimers Res Ther, 5, pp.S5~ (2013)
- Auchus AP, "Galantamine treatment of vascular dementia: A randomized trial", Neurology, 69, pp.448~458 (2007)
- Wilkinson D, "Donepezil in vascular dementia: A randomized, placebo-controlled study", Neurology, 61, pp.479~486 (2003)
- Black S, "Efficacy and tolerability of donepezil in vascular dementia:Positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial", Stroke, 34, pp.2323~2330 (2003)
- Ballard C, "Efficacy, safety and tolerability of rivastigmine capsules in patients with probable vascular dementia: The vantage study", Curr Med Res Opin, 24, pp.2561~2574 (2008)
- Dhillon S, "Rivastigmine transdermal patch: A review of its use in the management of dementia of the alzheimer's type", Drugs, 71, pp.1209~1231 (2011)
- Hogan DB, "Comparison studies of cholinesterase inhibitors for alzheimer's disease", Lancet Neurol, 3, pp.622~626 (2004)
- Schneider LS, "Lack of evidence for the efficacy of memantine in mild alzheimer disease", Arch Neurol, 68, pp.991~998 (2011)
- Tariot PN, "Memantine treatment in patients with moderate to severe alzheimer disease already receiving donepezil: A randomized controlled trial", JAMA, 291, pp.317~324 (2004)
- Howard R, "Donepezil and memantine for moderate-to-severe alzheimer's disease", N Engl J Med, 366, pp.893~903 (2012)
- Rosenberg PB, "Sertraline for the treatment of depression in alzheimer disease", Am J Geriatr Psychiatry, 18, pp.136~145 (2010)
- Banerjee S, "Sertraline or mirtazapine for depression in dementia (hta-sadd):A randomised, multicentre, double-blind, placebo-controlled trial", Lancet, 378, pp.403~411 (2011)
- Lonergan E, "Haloperidol for agitation in dementia", Cochrane Database Syst Rev, pp.CD002852~ (2002)
- Street JS, "Olanzapine treatment of psychotic and behavioral symptoms in patients with alzheimer disease in nursing care facilities: A double-blind, randomized, placebo-controlled trial. The hgeu study group", Arch Gen Psychiatry, 57, pp.968~976 (2000)
- Katz IR, "Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: A randomized, double-blind trial. Risperidone study group", J Clin Psychiatry, 60, pp.107~115 (1999)
- Kales HC, "Risk of mortality among individual antipsychotics in patients with dementia", Am J Psychiatry, 169, pp.71~79 (2012)
- Ballard C, "The dementia antipsychotic withdrawal trial (dart-ad): Long-term follow-up of a randomised placebo-controlled trial", Lancet Neurol, 8, pp.151~157 (2009)
- Rolinski M, "Cholinesterase inhibitors for dementia with lewy bodies, parkinson's disease dementia and cognitive impairment in parkinson's disease", Cochrane Database Syst Rev, 3, pp.CD006504~ (2012)
- Emre M, "Memantine for patients with parkinson's disease dementia or dementia with lewy bodies: A randomised, double-blind, placebo-controlled trial", Lancet Neurol, 9, pp.969~977 (2010)
- Sink KM, "Pharmacological treatment of neuropsychiatric symptoms of dementia: A review of the evidence", JAMA, 293, pp.596~608 (2005)
- Boxer AL, "Memantine in patients with frontotemporal lobar degeneration: A multicentre, randomised, double-blind, placebo-controlled trial", Lancet Neurol, 12, pp.149~156 (2013)