PROBING DRUG RELATED MENTAL DISORDERS OF AGING

为老年患者开出的药物的不良反应是 老年人精神障碍的常见原因。因此，研究 心理障碍引起的认知、情感和行为症状 对中枢作用药物的管理可以提供信息 关于中毒性脑病的症状。从… 从实用的角度来看，他们可以为临床医生和患者提供 与使用测试药物相关的风险信息 这可以促进预防残疾。因此，我们正在 建议进行随机、双盲、安慰剂对照 挑战研究，我们将在其中实施通常开出的处方 为期几周的药物治疗，直到健康、医学上稳定 老年志愿者。我们将测试活性药物的效果 与每周进行认知、抑郁、其他情绪测试的安慰剂相比 状态、嗜睡/警觉，以及每天的事件自我报告 既有积极影响，也有消极影响。这些药物将是 被研究的人之所以被选中，是因为他们常用，足够安全 允许管理老年志愿者，并被怀疑为 认知或情感毒性的原因。我们建议进行两项研究： 研究I将比较5周甲氧氯普胺(最多40周)的疗效 毫克/天)，舍曲林(200毫克/天)，萘普生(1000毫克/天)， 还有安慰剂。研究II将比较14周的辛伐他汀(最多20周 Mg/天)和安慰剂。分析将包括使用随机建模 回归模型。需要检验的假设是，这些药物 正在调查中的变化可能会导致行为毒性 在通过每周评估评估的认知表现方面；抑郁 或相关症状通过每周临床访谈或自我 关于抑郁和行为评定量表的报告； 负面情绪和/或减少的正面情绪，通过 每日自我报告。我们还将探索药物对 每日报道积极或消极的事件以及关于关系的报道 在日常事件和日常影响之间。

Adverse effects of medications prescribed for elderly patients are common causes of the mental disorders of aging. Therefore, studies of the cognitive, affective, and behavioral symptoms that result from the administration of centrally-acting medications can provide information about the symptoms that characterize the toxic encephalopathies. From a practical perspective, they can provide clinicians and patients with information on the risks associated with use of the tested medications that could facilitate the prevention of disability. Accordingly, we are proposing to conduct randomized, double-blind, placebo-controlled challenge studies in which we will administer commonly prescribed medications for a period of several weeks to healthy, medically stable elderly volunteers. We will test for effects of active medications versus placebo with weekly tests of cognition, depression, other mood states, and sleepiness/alertness, and with daily self-reports of events and of both positive and negative affects. The medications to be studied were selected because they are commonly used, sufficiently safe to allow administration to elderly volunteers, and are suspected as causes of cognitive or affective toxicity. We propose two studies: Study I will compare the effects of 5 weeks of metoclopramide (up to 40 mg/day), sertraline (up to 200 mg/day), naproxen (up to 1000 mg/day), and placebo. Study II will compare 14 weeks of simvastatin (up to 20 mg/day) with placebo. Analyses will include modeling using random regression models. The hypotheses to be tested are that the medications under investigation can cause behavioral toxicity manifest by changes in cognitive performance assessed through weekly assessments; depressive or related symptoms manifest through weekly clinical interviews or self- reports on depression and behavioral rating scales; and increased negative affect and/or decreased positive affect as assessed through daily self-reports. We will also explore the impact of medications on daily reports of positive or negative events and on the relationship between daily events and daily affect.