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NEUROLOGY 英文文献：帕金森病合并精神障碍和痴呆的诊疗
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American Academy of Neurology 于 2006年04月02日的论文 《Practice Parameter: Evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review)》 (编号：NEUROLOGY 2006;66:996-1002；中译名：帕金森症抑郁、精神障碍、痴呆的评测和治疗（循证医学综述）)中， 介绍了帕金森病合并精神障碍和痴呆的诊疗。
要点如下：
１、常用的抑郁和痴呆评测量表也可用于PD，但需要更加特异的评测工具。
２、对于PD精神障碍尚无广泛应用的有效评测量表。
３、氯氮平可有效治疗PD合并的精神障碍症状。
４、胆碱酯酶抑制剂可有效治疗PD合并痴呆，但是改善程度较小并且可能导致运动障碍的加重。
Practice Parameter: Evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review)
英文来源：NEUROLOGY 引用地址：http://www.parkinsonism.net/news/1/297.html
Report of the Quality Standards Subcommittee of the American Academy of Neurology
Objective: To make evidence-based treatment recommendations for patients with Parkinson disease (PD) with dementia, depression, and psychosis based on these questions: 1) What tools are effective to screen for depression, psychosis, and dementia in PD? 2) What are effective treatments for depression and psychosis in PD? 3) What are effective treatments for PD dementia or dementia with Lewy bodies (DLB)?
Methods: A nine-member multispecialty committee evaluated available evidence from a structured literature review using MEDLINE, and the Cochrane Database of Health and Psychosocial Instruments from 1966 to 2004. Additional articles were identified by panel members.
Results: The Beck Depression Inventory-I, Hamilton Depression Rating Scale, and Montgomery Asberg Depression Rating Scale should be considered to screen for depression in PD (Level B). The Mini-Mental State Examination and the Cambridge Cognitive Examination should be considered to screen for dementia in PD (Level B). Amitriptyline may be considered to treat depression in PD without dementia (Level C). For psychosis in PD, clozapine should be considered (Level B), quetiapine may be considered (Level C), but olanzapine should not be considered (Level B). Donepezil or rivastigmine should be considered for dementia in PD (Level B) and rivastigmine should be considered for DLB (Level B).
Conclusions: Screening tools are available for depression and dementia in patients with PD, but more specific validated tools are needed. There are no widely used, validated tools for psychosis screening in Parkinson disease (PD). Clozapine successfully treats psychosis in PD. Cholinesterase inhibitors are effective treatments for dementia in PD, but improvement is modest and motor side effects may occur.
与精神障碍、痴呆相关的资料
- 常用哪些药物可引起精神障碍
- 百度百科: 精神障碍
引起精神异常的常见药物有：(1)抗生素类药：①氯霉素：可引起幻听、幻视、定向力障碍及精神失常等，并可引起多发性神经炎；②合霉素：可引起意识模糊、兴奋话多、焦虑不安、情感淡漠、情绪低沉、恐怖、胡言乱语、幻视、幻听等；③青霉素G：定向障碍、行为怪异、惊恐、易激动、幻觉等；④氯喹：乏力、厌倦、易激动、兴奋冲动、精神失常、人格变化；⑤甲硝唑：兴奋话多或抑郁、失眠、行为紊乱等
精神障碍指的是大脑机能活动发生率乱，导致认识、情感、行为和意志等精神活动不同程度障碍的总称。常见的有情感性精神障碍、脑器质性精神障碍等。
文章整理：Golden Pig 最后修改: 2007-04-05
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