失智症病人不適切性行為的藥物治療

礙於國內保守社會文化，性議題容易被忽略且低估其困擾程度。由於失智症病人認知功能障礙，難以適當表達自己對於性及被愛的需求，導致出現不適切的行為，成為照顧者及家人的心理負擔。分散注意力並改善照顧技巧等非藥物方法為治療失智症病人不適切性行為的首要原則。綜整臨床文獻及使用經驗，失智症病人不適切性行為的藥物治療有SSRI（selective serotonin reuptake inhibitor）、抗精神病藥物、抗癲癇藥物及賀爾蒙治療。SSRI耐受性佳，可作為第一線用藥，由於性賀爾蒙治療男性失智症病人必須考量倫理及去勢的議題，須謹慎使用。目前並無失智症病人不適切性行為藥物治療相關臨床指引或專家共識建議，我們需更多的實證依據，提供未來病人臨床照護參考。

Keywords

失智症；不適切性行為；藥物治療

Parallel abstracts

Hindered by the conservative social culture of our country, sexual issues are easily overlooked, and distress levels underestimated. The cognitive impairments of dementia patients introduce hardship for them to adequately express their desires of sex and being loved, thus causing inappropriate behaviors and becoming a psychological burden for caregivers and family members. The main principles for treating inappropriate sexual behaviors in dementia patients are nonpharmacological approaches such as distraction and improvement of caring skills. Based on clinical literature and our experiences, pharmacotherapies for inappropriate sexual behaviors include selective serotonin reuptake inhibitors (SSRIs), antipsychotics, antiepileptics, and hormonal therapy. SSRIs are well tolerated and can be used as first-line medications. Hormonal therapy should concern the ethical and castration issues for male dementia patients. Currently, there are no treatment guidelines or expert consensus recommendations for pharmacotherapy for inappropriate sexual behaviors in dementia patients. More evidence is needed to provide references for future clinical care.

Parallel keywords

dementia ； inappropriate sexual behavior ； pharmacotherapy

Read-around

Altmetrics

失智症病人不適切性行為的藥物治療

Download

Read this ↓