失智症病人常常會伴有精神行為症狀，可能比健忘的問題更為棘手，是照顧者的 主要壓力來源，讓病人和照顧者的生活品質下降，也可能提早將病人送進護理之家， 增加家庭的經濟壓力，更可能因增加病人身體上的約束，而加速了認知功能的退化、 預後也變差。目前證據顯示並沒有強效的藥品來治療精神行為症狀，通常是病人出現 哪一類的精神行為問題，才會使用可治療相似精神症狀的藥品來對症下藥，如：使用 非典型抗精神劑、citalopram、dextromethorphan-quinidine 來治療激動；非典型抗精 神劑治療幻覺或妄想。另外，如果病人對抗失智症藥物治療精神行為症狀的效果不錯 的話，也許就能以一種藥品，同時治療知能問題及精神行為問題，如此對減低多重用 藥帶來相關的風險是很有幫助的。本文欲探討以現有藥物對於精神行為症狀的控制效 果，期能發現不同的治療契機，以增進病人和照顧者的生活品質。

ABSTRACT

Behavioral and psychological symptoms in dementia (BPSD) are common and may be more troubling than cognitive symptoms. Such symptoms can cause caregivers of patients with dementia particular stress, severely affecting the quality of life for both the patient and caregiver. The presence of neuropsychiatric symptoms can often accelerate or necessitate nursing home placement, thereby increasing economic stress on families, and in some cases even causing patients greater functional impairment and poorer prognosis due to certain practices prevalent in nursing homes (e.g., physical restraint). Although the evidence for the efficacy of BPSD treatments is not robust, some psychiatric drugs are often used to treat similar symptoms. Pharmacological options for treating agitation include atypical antipsychotic drugs, citalopram, and dextromethorphan-quinidine. Atypical antipsychotics may be most appropriate for hallucinations or delusions. In addition, if antidementia drugs are well tolerated by individuals with BPSD, they may bring additional benefits by reducing the risks associated with polypharmacy. In this study, we examined the effects of current agents on BPSD and determined different treatment options with the aim of improving quality of life for both patients and caregivers.