臨床神経学

教育講演9

認知症のBPSDの薬物治療:精神科からのメッセージ

橋本 衛

熊本大学医学部附属病院神経精神科〔〒860―8556 熊本県熊本市本荘1―1―1〕

Behavioral and psychological symptoms of dementia (BPSD) is the term defined as symptoms of disturbed perception, thought content, mood or behavior that frequently occur in patients with dementia. As BPSD can cause remarkable distress for both the patient and the caregiver, clinicians are required to treat the symptoms effectively. Before undertaking an intervention to BPSD, patients should be assessed in a detailed clinical interview to establish symptoms causing distress to the patient and/or caregiver. Initial intervention should focus on nonpharmacologic measures. However, pharmacologic intervention is necessary in many cases. There are many classes of medications to choose from for treating BPSD, but the evidence behind treatment is varied and confusing. Clinicians should discuss the potential risks and benefits of treatment with patients, and must ensure a balance between side effects and tolerability compared with clinical benefit and QOL. To provide medical care to the patients with dementia represents the comprehensive management of them, including differential diagnosis, treatment of BPSD and education of caregivers. Almost all of the patients with dementia develop BPSD during the course of the disease. As long as dementia is a neurological disorder, both neurologists and psychiatrists should work cooperatively in the treatment of dementia.
Full Text of this Article in Japanese PDF (258K)

(臨床神経, 51:857−860, 2011)
key words:認知症,BPSD,薬物療法,神経内科医

(受付日:2011年5月19日)