Aripiprazoleが有効であった薬剤抵抗性レビー小体型認知症の3症例

Drug-resistant Dementia with Lewy Bodies：Case report of 3 patients showing good response to aripiprazole treatment

抄録

　レビー小体型認知症(dementia with Lewy bodies；DLB)は抗精神病薬にhypersensitivityを来すため，治療薬としてdonepezilや抑肝散が試用されるようになった。我々は，donepezilと抑肝散の併用療法あるいは第二世代(非定型)抗精神病薬に抵抗を示し，aripiprazoleが有効であったDLB患者の3症例を経験した。この効果は，日本語版BEHAVE-ADにより確認された。症例1，2では有害事象がなく，症例3でみられた流涎，食欲低下はaripiprazoleの減量により消失した。したがって，aripiprazoleはDLBの行動・心理症状に有効で，安全に使用できる薬剤と考えられた。

　Donepezil and/or Yokukansan have been prescribed for patients with dementia with Lewy bodies (DLB), because these patients exhibit neuroleptic hypersensitivity. We report the cases of 3 patients with DLB who resisted treatment with donepezil, Yokukansan, and atypical antipsychotic drugs but responded to aripiprazole treatment. The effects of aripiprazole treatment were assessed and confirmed using the Japanese version of BEHAVE-AD rating scale. Aripiprazole-induced adverse effects were not observed in patients 1 and 2. However, excessive salivation and dysorexia were observed in patient 3, and these effects were alleviated by a reduction in aripiprazole dose. Therefore, we suggest that aripiprazole is effective and safe for the treatment of behavioral and psychological symptoms of DLB.