علاج مرض ألزهايمر مع الهياج والعدوانية

References

DOI: 10.1016/S0140-6736(25)01329-7

• Only the atypical antipsychotics risperidone (Europe and Canada) and brexpiprazole (USA, Canada, and Switzerland), and the typical antipsychotic haloperidol (Germany), are licensed for the treatment of agitation aggression for people with dementia.
• The first-line interventions should be aimed at reducing the source of stress (eg, treating chronic pain, teaching carers adaptive patient management behaviours, reducing sedative and anti-cholinergic medications, reducing environmental noise, or providing reassurance).
• After exclusion of other active medical conditions, regular analgesia is prescribed and staff are trained to develop a non-threatening communication pattern, using soft tones and calming, non-verbal behaviour, and to take more time during interactions.
• The best evidence on the pharmacological treatment of BPSD is for the treatment of agitation with non-opioid analgesics (effect size 0·48) and with the serotonin reuptake inhibitor citalopram (effect size 0·3).
• Agitation and aggression resolved within 2 weeks.