薬物による認知機能障害

Drug-induced Cognitive Impairment

高齢者では薬物による認知機能障害が生じやすい。せん妄や認知症は薬物の毒性により生じることが知られており，特に抗コリン作用の強い薬物は急性，あるいは慢性の認知機能障害の原因となる。向精神薬，抗うつ薬，抗てんかん薬もせん妄や認知症をきたしやすい。高齢者に対しては副作用の少ない薬物を選択して慎重に処方量の調整を行う，常に副作用の発現に注意を払うなど，薬物による認知機能障害の予防と早期発見が重要である。

Abstract

Elderly people are more likely than young people to develop cognitive impairments associated with medication use. One of the reasons for this is that renal and liver functions are often impaired in elderly people. Dementia and delirium (an acute confused state) are known to be associated with drug toxicity. Anticholinergic medications are common causes of both acute and chronic cognitive impairment. Psychoactive drugs, antidepressants and anticonvulsants can cause dementia and delirium. In addition, non-psychoactive drugs such as histamine H2 receptor antagonists, corticosteroids, NSAIDs (nonsteroidal anti-inflammatory agent), and cardiac medications, may cause acute or chronic cognitive impairment. Early diagnosis and withdrawal of the offending agent are essential for the prevention of drug-induced dementia and delirium.