Información del artículo
Resumen
La demencia por cuerpos de Lewy es un tipo de demencia más frecuente de lo que se consideraba hasta hace poco, y que se caracteriza por la escasez de recursos terapéuticos y la dificultad de tratamiento por la sensibilidad a los neurolépticos presente en muchos de los pacientes que la sufren. Aunque es necesaria una mayor investigación en este campo, la estandarización de los criterios para su diagnóstico ha permitido mejorar los datos procedentes de la investigación. Actualmente, los anticolines terásicos son fármacos de valor probado en esta indicación y hay pruebas cada vez mayores de que la memantina también puede resultar útil. Es importante no utilizar nunca neurolépticos típicos, que revisten gran peligro y, de entre los atípicos, aún a falta de resultados concluyentes, la quetiapina se perfila como la mejor opción.
Palabras clave:
Demencia por cuerpos de Lewy
Memantina
Anticolinesterásicos
Parkinsonismo
Abstract
Lewy body dementia (LBD) is more frequent than previously considered and is characterized by the scarcity of therapeutic resources and the difficulty of treatment since many patients are hypersensitive to neuroleptics. Although further research is required in this field, standardization of the diagnostic criteria has improved the data obtained from research. Currently, anticholinesterase drugs have proven utility in LBD and there is increasing evidence that memantine can also be useful. Typical neuroleptics are dangerous in these patients and should never be used. Among atypical neuroleptics, quetiapine is the best option, although conclusive data are lacking.
Keywords:
Lewy body dementia
Memantine
Anticholinesterase drugs
Parkinsonism
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Bibliografía
[1]
R. Dodel, I. Csoti, G. Ebersbach, G. Fuchs, M. Hahne, W. Kuhn, et al.
Lewy body dementia and Parkinson's disease with dementia.
J Neurol., 255 (2008), pp. 39-47
[2]
I.G. McKeith, D.W. Dickson, J. Lowe, M. Em-re, J.T. O’Brien, H. Feldman, et al.
Diagnosis and management of demen tia with Lewy bodies: third report of the DLB Consortium.
Neurology., 65 (2005), pp. 1863-1872
[3]
P.T. Nelson, R.J. Kryscio, E.L. Abner, F.A. Sch mitt, G.A. Jicha, M.S. Mendiondo, et al.
Acetylcholinesterase inhibitor treatment is associated with relatively slow cogntive decline in patients with Alzheimer's disease and AD+DLB.
Journal of Alz heimer's Disease: JAD., 16 (2009), pp. 29-34
[4]
R.E. Mrak, W.S.T. Griffin.
Dementia with Lewy bodies: definition, diagnosis, and pathogenic relationship to Alzheimer's disease.
Neuropsychiatric Disease and Treatment., 3 (2007), pp. 619-625
[5]
Z. Walker, T. Stevens.
Dementia with Lewy bodies: clinical characteristics and diagnostic criteria.
Journal of Ge riatric Psychiatry and Neurology., 15 (2002), pp. 188-194
[6]
D.J. Burn.
Update ondementiawithLewy bodies.
Curr Neurol Neurosci Rep., 5 (2005), pp. 339-344
[7]
R. Camicioli, S. Gauthier.
Clinical trials in Parkinson's disease dementia and dementia with Lewy bodies.
The Canadian journal of neurological sciences Le Jour nal Canadien des Sciences Neurologiques., 34 (2007), pp. S109-S117
[8]
P.T. Francis, E.K. Perry.
Cholinergic and other neurotransmitter mechanisms in Parkinson's disease.
Parkinson's disease dementia, and dementia with Lewy bo dies. Mov Disord., 22 (2007), pp. S351-S357
[9]
S. Mori, E. Mori, E. Iseki, K. Kosaka.
Effiacy and safety of donepezil in patients with dementia with Lewy bodies: preliminary findings from an open-label study.
Psychiatry Clin Neuros ci., 60 (2006), pp. 190-195
[10]
C. Shea, C. Macknight, K. Rockwood.
Do nepezil for treatment of dementia with Lewy bodies: a case series of nine pa tients.
Int Psychogeriat., 10 (1998), pp. 229-238
[11]
W. Samuel, M. Caligiuri, D. Galasko, J. La cro, M. Marini, F.S. McClure, et al.
Bet ter cognitive and psychopathologic res ponse to donepezil in patients prospec tively diagnosed as dementia with Lewy bodies: a preliminary study.
Int J Geriatr Psychiatry., 15 (2000), pp. 794-802
[12]
I.G. McKeith, J.B. Grace, Z. Walker, E.J. Byrne, D. Wilkinson, T. Stevens, et al.
Ri vastigmine in the treatment of demen tia with Lewy bodies: preliminary fin dings from an open trial.
Int J Geriatr Psychiatry., 15 (2000), pp. 387-392
[13]
K.R. Edwards, L. Hershey, L. Wray, E.M. Bed narczyk, D. Lichter, M. Farlow, et al.
Efficacy and safety of galantamine in pa tients with dementia with Lewy bodies: a 12-week interim analysis.
Dem Geriatr Cogn Disord., 17 (2004), pp. 40-48
[14]
K. Edwards, D.R. Royall, L. Hershey, D. Li chter, A. Hake, M.R. Farlow, et al.
Ef ficacy and safety of galantamine in pa tients with dementia with Lewy bodies: a 24-week open-label Study.
Dem Geriatr Cogn Disord., 23 (2007), pp. 401-405
[15]
A.J. Thomas, D.J. Burn, E.N. Rowan, E. Little-Wood, J. Newby, D. Cousins, et al.
A comparison of the efficacy of donepezil in Parkinson's disease with dementia and dementia with Lewy bodies.
Int J Geriatr Psychiatry., 20 (2005), pp. 938-944
[16]
I. McKeith, T. Del Ser, P. Spano, M. Em-re, K. Wesnes, R. Anand, et al.
Ef ficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebocontrolled international study.
Lancet., 356 (2000), pp. 2031-2036
[17]
T.S.C. Minett, A. Thomas, L.M. Wilkinson, S.L. Daniel, J. Sanders, J. Richardson, et al.
What happens when donepezil is sud denly withdrawn?.
An open label trial in dementia with Lewy bodies and Par kinson's disease with dementia. Int J Geriatr Psychiatry., 18 (2003), pp. 988-993
[18]
A. Gustavsson, R. Van der Putt, L. Jönsson, R. Mcshane.
Economic evaluation of cholinesterase inhibitor therapy for de mentia: comparison of Alzheimer's disea se and Dementia with Lewy bodies.
In t J Geriatr Psychia try., 24 (2009), pp. 1072-1078
[19]
C.G. Ballard, K.A. Chalmers, C. Todd, I.G. McKeith, J.T. O’Brien, G. Wilcock, et al.
Cholinesterase inhibitors reduce cortical Abeta in dementia with Lewy bodies.
Neurology., 68 (2007), pp. 1726-1729
[20]
M. Bhasin, E. Rowan, K. Edwards, I. McKeith.
Cholinesterase inhibitors in dementia with Lewy bodies: a compa rative analysis.
Int J Geriatr Psychiatry., 22 (2007), pp. 890-895
[21]
M. Emre.
Memantine: a new ho pe for treatment of Lewy body-related dementias?.
Lancet Neurol., 8 (2009), pp. 594-595
[22]
B.H. Ridha, K.A. Josephs, M.N. Rossor.
De lusions and hallucinations in dementia with Lewy bodies: worsening with me mantine.
Neurology., 65 (2005), pp. 481-482
[23]
M. Menéndez-González, M.T. Calatayud, B. Blázquez-Menes.
Exacerbation of Lewy bodies dementia due to memanti ne.
Journal of Alzheimer's Disease: JAD., 8 (2005), pp. 289-291
[24]
J.M. Alisky.
Memantine-induced decom pensationin a patient with Lewy body dementia.
Ann Acad Med Singapore., 36 (2007), pp. 707
[25]
D. Aarsland, C. Ballard, Z. Walker, F. Bos tröm, G. Alves, K. Kossakowski, et al.
Memantine in patients with Parkin son's disease dementia or dementia with Lewy bodies: a double-blind, placebo-controlled, multicentre trial.
Lancet Neurol., 8 (2009), pp. 613-618
[26]
O.S. Levin, L.A. Batukaeva, I.G. Smolentseva, N.A. Amosova.
Efficacy and safety of memantineinLewybodydementia.
Neurosci Behav Physiol., 39 (2009), pp. 597-604
[27]
M. Emre, M. Tsolaki, U. Bonuccelli, A. Des tée, E. Tolosa, A. Kutzelnigg, et al.
Memantine for patients with Parkin son's disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial.
Lancet Neurol., 9 (2010), pp. 969-977
[28]
C. Johansson, C. Ballard, O. Hansson, S. Palmqvist, L. Minthon, D. Aarsland, et al.
Efficacy of memantine in PDD and DLB: an extension study including wa shout and openlabel treatment.
Int J Geriatr Psychiatry., 26 (2011), pp. 206-213
[29]
O’Brien JT, Burns A. Clinical practi ce with anti-dementia drugs: a revised (second) consensus statement from the British Association for Psychopharma cology. J Psychopharmacol (Oxford, England). 2010 Nov 18.[Epub ahead of print].
[30]
H.H. Fernández, C.K. Wu, B.R. Ott.
Phar macotherapy of dementia with Lewy bo dies.
Expert Opin Pharmacothe r., 4 (2003), pp. 2027-2037
[31]
S. Molloy, T. Minett, J.T. O’Brien, I.G. McKeith, D.J. Burn.
Levodopa use and sleep in patients with dementia with Lewy bodies.
Mov Disord., 24 (2009), pp. 609-612
[32]
S.A. Molloy, E.N. Rowan, J.T. O’Brien, I.G. McKeith, K. Wesnes, D.J. Burn.
Ef fect of levodopa on cognitive function in Parkinson's disease with and without de mentia and dementia with Lewy bodies.
J Neurol Neurosurg Psychiatry., 77 (2006), pp. 1323-1328
[33]
J.G. Goldman, C.G. Goetz, M. Brandabur, M. Sanfilippo, G.T. Stebbins.
Effects of dopaminergic medications on psychosis and motor function in dementia with Lewy bodies.
Mov Disord., 23 (2008), pp. 2248-2250
[34]
C. Lucetti, C. Logi, P. Del Dotto, C. Berti, R. Ceravolo, F. Baldacci, et al.
Levodopa response in dementia with lewy bodies: A 1-year follow-up study.
Parkinsonism & Related Disorders., 16 (2010), pp. 522-526
[35]
N. Hirono, J.L. Cummings.
Neuropsychia tric aspects of dementia with Lewy bo dies.
Curr Psychiatry Rep., 1 (1999), pp. 85-92
[36]
D. Weintraub, H.I. Hurtig.
Presentation and management of psychosis in Parkin son's disease and dementia with Lewy bodies.
Am J Psychia try., 164 (2007), pp. 1491-1498
[37]
D. Aarsland, R. Perry, J.P. Larsen, I.G. McKeith, J.T. O’Brien, E.K. Perry, et al.
Neuroleptic sensitivity in Parkin son's disease and parkinsonian demen tias.
J Clin Psychiatry., 66 (2005), pp. 633-637
[38]
A. Baskys.
Lewy body dementia: the lit mus test for neuroleptic sensitivity and extrapyramidal symptoms.
J Clin Psychiatry., 65 (2004), pp. 16-22
[39]
H. Frieling, T. Hillemacher, M. Ziegenbein, B. Neundörfer, S. Bleich.
Treating dopamimetic psychosis in Parkinson's disease: structured review and meta analysis.
Eur Neuropsychopharma col., 17 (2007), pp. 165-171
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