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Agitatie en agressie bij dementie: ontwerp van een evidence-based algoritme voor medicamenteuze behandeling

  • Published:
Tijdschrift voor Neuropsychiatrie en Gedragsneurologie

Samenvatting

Terwijl onderzoek naar de mogelijkheden van ziektemodulerende medicatie bij dementie een boeiende ontwikkeling doormaakt, is de aandacht in de huidige klinische praktijk toch nog vooral gericht op symptoombestrijding. De behandeling van probleemgedrag speelt daarin een hoofdrol. De wetenschappelijke, evidence based (EBM), literatuur over analyse en behandeling van probleemgedrag is echter beperkt en het ontbreekt dan ook aan breder inzetbare richtlijnen.

Om hierin verandering te brengen werd door een werkgroep van ervaren specialisten uit verschillende disciplines een eerste praktisch bruikbare leidraad ontworpen op basis van beschikbare EBM-gegevens, voor medicamenteuze behandeling van agitatie en agressie bij dementie. Uitgangspunt daarbij is dat agitatie en agressie uitingen zijn van distress (uitgedrukt in het concept BPSD: ‘behavioral and psychological symptoms in dementia’) en een daarop gerichte analyse vereisen. Pas als niet-medicamenteuze maatregelen ter vermijding van distress falen kan in acute of niet-acute situaties medicamenteuze behandeling gewenst zijn. Er zijn maar weinig middelen die daarbij de toets der kritiek kunnen doorstaan en/of breed toepasbaar zijn. Vervolgens vereist de toepassing van medicatie een nauwgezette monitoring van het effect. De doelstelling van ons algoritme is vooral ook gestructureerde ervaring op te doen met medicamenteuze behandeling van agitatie en agressie bij dementie en verder wetenschappelijk onderzoek naar analyse en behandeling van BPSD te stimuleren.

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Authors and Affiliations

  1. Orbis GGZ, Geleen-Sittard, The Netherlands

    Dr. Peter van Domburg, Marion Vromen & Walther Sipers

  2. Mondriaan, Divisie Ouderen, Heerlen, The Netherlands

    Janine Collet

  3. Vivre, Locatie Klevarie, Maastricht, The Netherlands

    Monique Durlinger

  4. GGzE, Centrum Ouderenpsychiatrie, Eindhoven, The Netherlands

    Serge Roufs

  5. Dept. of General Practice and Dept. Health Services Research, Caphri – School for Public Health and Primary Care, Maastricht, The Netherlands

    Jos Schols

  6. MUMC, Maastricht, The Netherlands

    Mike Verkaaik & Frans Verhey

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  1. Dr. Peter van Domburg
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Correspondence to Dr. Peter van Domburg.

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namens het Dementieplatvorm Zuid

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van Domburg, D.P., Vromen, M., Collet, J. et al. Agitatie en agressie bij dementie: ontwerp van een evidence-based algoritme voor medicamenteuze behandeling. Tijdsvoor Neuropsy en Gedragsneuro 1, 36–44 (2013). https://doi.org/10.1007/s40533-013-0009-3

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