Sigma-1 receptor agonist fluvoxamine for postoperative delirium in older adults report of three cases 英文参考文献.docVIP

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Sigma-1 receptor agonist fluvoxamine for postoperative delirium in older adults report of three cases 英文参考文献.doc

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Sigma-1 receptor agonist fluvoxamine for postoperative delirium in older adults report of three cases 英文参考文献

Furuse and Hashimoto Annals of General Psychiatry 2010, 9:28 /content/9/1/28 CASE REPORT Open Access Sigma-1 receptor agonist fluvoxamine for Case report postoperative delirium in older adults: report of three cases Tsutomu Furuse*1 and Kenji Hashimoto2 Abstract Background: Postoperative delirium is a topic of great importance in the geriatric surgical specialty. Although antipsychotic drugs are the medications most frequently used to treat this syndrome, these drugs are associated with a variety of adverse events, including sedation, extrapyramidal side effects, and cardiac arrhythmias. Drug treatment for postoperative delirium requires careful consideration of the balance between the effective management of symptoms and potential adverse effects. Methods: We report on a Japanese woman (an 86-year-old (open reduction and internal fixation of the right femoral neck fracture), and two Japanese men (an 86-year-old (abdominal aortic aneurysm stent grafting), and a 77-year-old (right upper lobectomy due to lung tumour)) in which the selective serotonin reuptake inhibitor and sigma-1 receptor agonist fluvoxamine was effective in ameliorating the postoperative delirium of these patients. Results: Delirium Rating Scale scores in these patients dramatically decreased after treatment with fluvoxamine. Conclusions: Doctors should consider fluvoxamine as an alternative approach to treating postoperative delirium in older patients in order to avoid the risk of side effects and increased mortality by antipsychotic drugs. Background The endoplasmic reticulum protein sigma-1 receptors Postoperative delirium is a common and deleterious play a key role in Ca2+ signalling and cell survival, and complication in older patients following a major opera- have been shown to regulate a number of neurotransmit- tion. The recognition and treatment of postoperative ter systems in the brain [7-12]. The selective serotonin delirium is c