Neuroleptic discontinuation during dementia care: a recent trial and its implications for practice.
Neuroleptic discontinuation during dementia care: a recent trial and its implications for practice.
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痴呆症护理期间停用抗精神病药：最近的一项试验及其对实践的影响。
DOI：
10.1038/ncpneuro0884
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发表时间：
2008
影响因子：
--
通讯作者：
Onyike,ChiadiU
中科院分区：
文献类型：
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作者：
Onyike,ChiadiU
本实践点评论讨论了DART-AD试验，这是一项调查神经抗精神病药物停用的前瞻性研究。阿尔茨海默型痴呆症患者在住院治疗并服用抗精神病药物3个月或更长时间后，随机接受两种为期12个月的干预措施之一：继续或停止抗精神病药物治疗。主要目的是确定停用抗精神病药物是否能改善认知结果。6个月后，停用抗精神病药物对阿尔茨海默病患者的认知或功能没有损害，除了那些在登记时神经精神病学评分为≥15的患者(这些患者在12个月时神经精神病学评分更高)。本评注强调了与翻译这些结果有关的方法学问题，并考虑了对日常实践的影响。从实践的角度来看，明智的处方和及时的停药似乎可以优化神经抗精神病药的风险-利益平衡。
This Practice Point commentary discusses the DART-AD trial, a prospective study investigating neuroleptic discontinuation. Patients with dementia of the Alzheimer type who were in residential care and taking neuroleptics for 3 months or longer, were randomized to receive one of two 12-month interventions: continuation or discontinuation of neuroleptic treatment. The primary aim was to determine whether neuroleptic discontinuation improves cognitive outcomes. After 6 months, neuroleptic discontinuation was not detrimental to cognition or function in patients with Alzheimer's disease, except for those who had Neuropsychiatric Inventory scores ≥15 at enrollment (these patients had even higher Neuropsychiatric Inventory scores at 12 months). This commentary highlights methodological issues pertinent to the translation of these results and also considers implications for everyday practice. From a practice perspective, it would seem that judicious prescribing and timely discontinuation might optimize the risk–benefit balance of neuroleptics.