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Nervenheilkunde 2013; 32(10): 737-742
DOI: 10.1055/s-0038-1633367
Demenz
Schattauer GmbH

S3-Leitlinien Demenzen

Symptomatische TherapieS3-Guidelines Dementia
L. Hausner
1   Zentralinstitut für Seelische Gesundheit, Abteilung für Gerontopsychiatrie, Medizinische Fakultät Mannheim, Universität Heidelberg
,
L. Frölich
1   Zentralinstitut für Seelische Gesundheit, Abteilung für Gerontopsychiatrie, Medizinische Fakultät Mannheim, Universität Heidelberg
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Further Information

Publication History

eingegangen am: 20 June 2013

angenommen am: 26 June 2013

Publication Date:
05 February 2018 (online)

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Zusammenfassung

Die Therapie der Demenzen umfasst eine pharmakologische Behandlung und psychosoziale Interventionen für Patienten und Angehörige im Kontext eines symptom- und schweregradabhängigen Gesamtbehandlungsplans. Primäres Ziel ist die Behandlung der Kernsymptomatik kognitive Störungen, ADL-Defizite und, falls notwendig, Therapie der psychischen und Verhaltenssymptome. Evidenzbasiert ist die stadiumabhängige Behandlung der AD mit AChE-I und Memantin. Die höchste verträgliche Dosis sollte angestrebt werden sowie eine kontinuierliche Langzeittherapie. Es ist gerechtfertigt, eine gemischte Demenz wie eine AD zu behandeln. Die Behandlung der VD mit einem AChE-I oder Memantin ist eine Off-label-Behandlung ohne vollständig überzeugenden Wirksamkeitsbeleg. Es gibt keine Evidenz zur Behandlung kognitiver Symptome oder Verhaltenssymptome bei Patienten mit FTD oder LKD. Für die antidementive Behandlung der PD ist Rivastigmin wirksam und zugelassen.

Summary

The treatment of dementia comprises a pharmacological treatment and psychosocial interventions for patients and families in the context of a symptom and severity-dependent overall treatment plan. The primary goal is to treat the core symptoms cognitive impairment, ADL deficits and, if necessary, treatment of mental and behavioral symptoms. The stage-dependent treatment of AD with AChE-I and memantine is evidencebased. The highest tolerated dose should be targeted as well as a long-term treatment. Mixed dementia should be treated like AD. The treatment of VD with AChE-I or memantine is an off-label treatment without convincing efficacy. There is no evidence for the treatment of cognitive symptoms or behavioral symptoms in patients with FTD or LBD. Rivastigmine is effective and approved as antidementia drug in PD.

Schlüsselwörter

Alzheimer - S3-Leitlinien - symptomatische Therapie

Keywords

Alzheimer - S3-Guidelines - symptomatic therapy
 

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