脳障害と治療

概要

Pharmacotherapies for Behavioral and Psychological Symptoms of Dementia with Alzheimer’s Disease: Two Subcategories of these Symptoms

Koji Hori, Misa Hosoi, Kimiko Konishi , Mitsugu Hachisu , Hiroi Tomioka , Michiho Sodenaga , Chiaki Hashimoto, Ouga Sasaki, Mioto Maedomari, Itsuku Suzuki, Masanori Tadokoro , Sachiko Tsukahara, Hiroyuki Kamatani, Masayuki Tani, Hiroaki Tanaka, Yuka Kitajima and Hiroki Kocha

In this article, we reviewed our previous articles those showed that ageing process and disease progression connected affective disturbances and anxiety with delusion, hallucination and aggressiveness and those behavioral and psychological symptoms of dementia (BPSD) is related with bipolarity (BT), and we comment the pharmacotherapies for BPSD in Alzheimer’s disease (AD). There are two types of BPSD with AD. One is related with the progressions of AD that is caused by the deteriorated lesions by AD pathology. Therefore, these symptoms are ameliorated by the treatment for AD, that is, cholinesterase inhibitors or N-methyl-D-aspartate receptors antagonist. The other is related with brain reserve (BR) and cognitive reserve (CR). In this pattern, the information processing system is not deteriorated. However, low BR caused by BT and low CR modulate the behaviors etwas eccentric. When lowering of brain volume caused by AD pathology is added, i.e., BR is lower than before, BPSD appears. Therefore, in this patter, SSRI, atypical antipsychotics and anticonvulsants those have the treatment option for bipolar disorders, galanatmine and SNRI are needed.