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Fortschr Neurol Psychiatr 2002; 70(2): 78-83
DOI: 10.1055/s-2002-19920
Originalarbeit
Georg Thieme Verlag Stuttgart · New York

Einfluss der Therapie mit Azetyl-Cholinesterase-Inhibitoren (AChEI) auf psychopathologische Symptome bei der Alzheimer-Krankheit

Influence of Treatment with Acetyl-Cholinesterase Inhibitors on Psychopathological Symptoms in Alzheimer's DiseaseM.  Rösler1 , U.  Frey2
  • 1Arbeitsgruppe Gerontopsychiatrie (Prof. Dr. K. Wanke/Prof. Dr. M. Rösler) Universitätskliniken des Saarlandes, Homburg
  • 2Arbeitsgruppe Gerontopsychiatrie (Prof. Dr. K. Wanke/Prof. Dr. M. Rösler) Universitätsnervenklinik Homburg, Klinik für Psychiatrie und Psychotherapie (Prof. Dr. K. Wanke), Universitätskliniken des Saarlandes, Homburg
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Publikationsdatum:
01. Februar 2002 (online)

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Zusammenfassung

Nachdem zunächst die therapeutische Beeinflussung der kognitiven Defizite bei Patienten mit einer Demenz vom Alzheimer Typ (DAT) ganz im Vordergrund stand, wird in letzter Zeit zunehmend den psychopathologischen Symptomen und Verhaltensstörungen (Behavioral and Psychological Symptoms of Dementia, BPSD) Beachtung geschenkt. Häufig sind nämlich gerade diese für die Betroffenen und für die sie versorgenden Personen erheblich belastend. Die Therapiemöglichkeiten sind mit der Zulassung von Azetyl-Cholinesterase-Inhibitoren (AChEI) der zweiten Generation in den letzten Jahren erweitert worden. Bei der klinischen Evaluation dieser Medikamente wurden zunächst deren Effekte auf die kognitiven Funktionen und Alltagsfertigkeiten bei DAT-Patienten untersucht. Zwischenzeitlich mehren sich Berichte, nach denen eine cholinerge Therapie auch BPSD bei DAT-Patienten günstig beeinflussen kann. Dadurch kann eine deutliche Entlastung der Patienten und Verminderung des Pflegebedarfs erreicht werden. Die Datenlage bezüglich der drei am Markt eingeführten AChEI spricht eindeutig für einen günstigen Einfluss im Sinne der Symptomreduktion oder der Symptomstabilisierung auf die BPSD in ihrer Gesamtheit. Es liegen zunehmend Hinweise dafür vor, dass es spezifische Symptomgruppen gibt, die besonders positiv auf die AChEI-Therapie ansprechen. Halluzinationen, depressive Symptome, Aggressivität und Reizbarkeit zeigen deutliche Symptomreduktionen unter einer Behandlung mit AChEI.

Abstract

The treatment of the cognitive deficits has been the major focus in patients with Alzheimer's disease (DAT) so far. Recently there is increasing interest in Behavioral and Psychological Symptoms of Dementia (BPSD), which can place much burden on DAT patients and their caregivers. With the introduction of Acetylcholinesterase Inhibitors (AChEI) of the second generation the therapeutic armament has been extended. The clinical evaluation of AChEI has found growing evidence that these compounds do not only improve cognitive abilities and activities of daily living (ADL), but also BPSD. The given data regarding the three AChEI available on the market allow the conclusion that there is a general improvement in BPSD. Beside these particularly positive effects on hallucinations, mood symptoms, aggressiveness, and agitation seem possible but need further clarification.

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Prof. Dr. M. Rösler

Universitätsnervenklinik · Universitätskliniken des Saarlandes

66421 Homburg