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Treatment and Care for Elderly Patients with Dementia with Lewy Bodies Presenting with Delusional Misidentification Syndrome Including Capgras Syndrome: Severe Psychiatric Symptoms Associated with Dementia with Lewy Bodies Michitaka Funayama 1 1Department of Neuropsychiatry, Ashikaga Red Cross Hospital Keyword: レビー小体型認知症 , 抗精神病薬 , ドパミンアゴニスト , 妄想性誤認症候群 , 電気痙攣療法 , dementia with Lewy bodies , antipsychotics , dopamine agonists , delusional misidentification syndrome , electroconvulsive therapy pp.685-691
Published Date 2022/5/1
DOI https://doi.org/10.11477/mf.1416202097
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Abstract

The treatment and care for severe psychiatric symptoms associated with dementia with Lewy bodies is challenging. This is especially true for elderly patients because the use of antipsychotics is associated with an attendant mortality risk. In this article, dementia patients with Lewy bodies who presented with severe psychiatric symptoms such as Capgras syndrome (delusional misidentification syndrome), are described, and pharmacological and non-pharmacological strategies to address these symptoms are discussed. Measures to be avoided include antipsychotic administration and physical restraint, both of which often lead to medical conditions and a bedridden status. Conversely, changing antiparkinsonian drugs (levodopa rather than dopamine agonists), cholinesterase inhibitor administration, physical rehabilitation, and providing a supportive, patient-friendly environment may help improve psychiatric symptoms or maintain functionality. In some cases, electroconvulsive therapy may be effective for severe psychiatric symptoms.


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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