Apathy in Alzheimer's disease: any effective treatment?
Apathy in Alzheimer's disease: any effective treatment?
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DOI：
10.1155/2014/421385
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发表时间：
2014
影响因子：
--
通讯作者：
Amenta F
中科院分区：
文献类型：
--
作者：
Rea R;Carotenuto A;Fasanaro AM;Traini E;Amenta F
Objective.该综述评估了阿尔茨海默病（AD）患者冷漠的药物治疗的有效性。方法.对过去10年来评估药物治疗对AD冷漠症影响的已发表临床试验进行了系统性文献检索。结果分析中纳入了14项被认为质量良好的研究（4项随机对照试验，9项开放标签研究和1项回顾性分析）。在9项研究中对胆碱酯酶抑制剂进行了研究，单胺能化合物如哌甲酯和莫达非尼分别在2项试验和1项试验中进行了研究，银杏叶（EGb 761提取物）和西酞普兰各在1项研究中进行了研究。胆碱酯酶抑制剂在1项RCT研究中未显示统计学显著性作用，但在3项开放标签研究中与改善相关。哌醋甲酯引起小但显著的活性，伴随有相关的副作用，如高血压、咳嗽和骨关节疼痛。EGb 761耐受性良好，可对抗冷漠。其他治疗引起适度的改善或无效。结论.冷漠治疗仍然是一个挑战，目前为止，任何特定的药物治疗都没有明显的优势。根据AD患者情感淡漠诊断的最新指南开展对照研究是可取的。
Objective. This review has evaluated the effectiveness of pharmacological treatment of apathy in patients with Alzheimer's disease (AD). Methods. A systematic literature search was conducted on published clinical trials assessing the effects of pharmacological treatment on apathy in AD over the last 10 years. Results. Fourteen studies considered of good quality were included in the analysis (4 randomized controlled trials, 9 open-label studies, and 1 retrospective analysis). Cholinesterase inhibitors were investigated in 9 studies, monoaminergic compounds such as methylphenidate and modafinil in two trials and one trial, respectively, and Ginkgo biloba (EGb 761 extract) and citalopram in one study each. Cholinesterase inhibitors did not show statistical significant effect in 1 RCT study but were associated to improvement in 3 open-label studies. Methylphenidate elicited a small but significant activity accompanied by relevant side effects such as high blood pressure, cough, and osteoarticular pain. EGb 761 was well tolerated and countered apathy. Other treatments induced modest improvements or were ineffective. Conclusions. Apathy treatment remains a challenge and there is no evident advantage of any specific pharmacotherapy tested so far. The development of controlled studies according to updated guidelines for the diagnosis of apathy in patients with AD is desirable.
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影响因子：
5.3
作者：
Frakey, Laura L.;Solloway, Stephen;Malloy, Paul
通讯作者：
Malloy, Paul
影响因子：
6
作者：
Stanton, Biba R.;Leigh, P. Nigel;Brown, Richard G.
通讯作者：
Brown, Richard G.
影响因子：
6.7
作者：
Weiner, MF;Hynan, LS;White, C
通讯作者：
White, C
DOI：
10.1016/s1543-5946(05)80020-0
发表时间：
2005-09-01
期刊：
The American journal of geriatric pharmacotherapy
影响因子：
--
作者：
Cummings, Jeffrey L;Koumaras, Barbara;Mirski, Dario
通讯作者：
Mirski, Dario
影响因子：
2.9
作者：
Herrmann, Nathan;Rothenburg, Lana S.;Lanctot, Krista L.
通讯作者：
Lanctot, Krista L.