Donepezil for the treatment of behavioral disturbances in Alzheimer's disease: a 6-month open trial

Barak, Yoram; Bodner, Ehud; Zemishlani, Hanna; Mirecki, Ilona; Aizenberg, Dov

doi:10.1016/s0167-4943(01)00187-x

Cited by 27 publications

(15 citation statements)

References 10 publications

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“…Rapid resolution of hallucinations and delirium after the initiation of donepezil was originally described in case reports 11,12 and subsequently confirmed in placebo-controlled randomized clinical trials in which behavioral symptoms scores were used as a secondary outcome variable. 13,14 Amelioration of neuropsychiatric symptoms was also reported in several dedicated, albeit small, double-blind, 15 and openlabel [16][17][18] studies. A few years later, the notion that donepezil improves neuropsychiatric symptoms was shown in a randomized, placebo-controlled trial in 134 patients with mild-to-moderate Alzheimer disease in which change in score on the Neuropsychiatric Inventory (NPI) was used as the primary outcome measure.…”

mentioning

confidence: 75%

Safety and Effectiveness of Donepezil on Behavioral Symptoms in Patients With Alzheimer Disease

Carrasco¹,

Agüera²,

Gil

et al. 2011

Alzheimer Disease &Amp; Associated Disorders

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The objective of this study was to evaluate the prevalence and treatment responsiveness of neuropsychiatric symptoms in patients with mild to moderately severe Alzheimer disease recruited in a naturalistic treatment setting in Spain. All the patients, who matched the prescribing recommendations for donepezil and were able to participate in the study, received donepezil (5 to 10 mg/d) for 6 months. The primary outcome measure was the incidence of adverse events. Secondary outcome measures were neuropsychiatric function measured by the Neuropsychiatric Inventory (NPI), the Mini-Mental State Evaluation, and caregiver burden measured by the Zarit scale. Five hundred and twenty-nine patients were included of which 455 completed the study. The mean baseline NPI score was 19.1. Sixty-five patients (12.3%) experienced an adverse event. The most frequent adverse events were diarrhea and agitation (<2%). Seventeen patients (3%) presented with a neuropsychiatric adverse event and 11 (2%) patients presented with a neurologic adverse event over the course of the study. NPI scores improved by 34.4% over the course of the study, with all items showing a statistically significant improvement. Mini-Mental State Evaluation scores and Zarit caregiver burden scores also improved by 1.27 points and 5.9 points, respectively. This study showed a low incidence of adverse events accompanied by an improvement in the neuropsychiatric and cognitive functions in patients with mild to moderately severe Alzheimer disease treated with donepezil in a community setting in Spain. Donepezil also reduced caregiver burden.

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mentioning

confidence: 75%

Safety and Effectiveness of Donepezil on Behavioral Symptoms in Patients With Alzheimer Disease

Carrasco¹,

Agüera²,

Gil

et al. 2011

Alzheimer Disease &Amp; Associated Disorders

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“…The potential behavioral effect of ChEIs in AD have been also claimed by several studies, 26,27 although with conflicting results. Furthermore, a differential effect on various psychopathological symptoms has been reported for different ChEIs, with psychosis, agitation, wandering, and anxiety being the most consistently described sensitive symptoms across studies.…”

Section: Discussionmentioning

confidence: 95%

Cognitive and Psychopathologic Response to Rivastigmine in Dementia With Lewy Bodies Compared to Alzheimer’s Disease: A Case Control Study

Rozzini

Chilovi

Bertoletti

et al. 2007

Am J Alzheimers Dis Other Demen

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Cholinesterase inhibitors (ChEIs) are effective in improving cognition and behavior in patients affected by Alzheimer's disease (AD) as well as by Lewy bodies dementia (DLB). The authors compared the effect of rivastigmine in the treatment of cognitive impairment and behavioral and psychological symptoms of dementia (BPSD) in 30 AD and in 30 DLB patients. At baseline, DLB compared to AD patients showed a greater number of extrapyramidal symptoms (P < .005) and were similar regarding cognitive symptoms and BPSD. After treatment, both groups showed a comparable cognitive and psycho-behavioral improvement. A significant difference between AD and DLB patients was found for hallucinations (P < .002). Rivastigmine produces comparable cognitive benefits in patients with DLB and AD and also a significant improvement of behavioral disorders. These findings support the view that ChEIs should be considered a first-line treatment of the cognitive and psycho-behavioral symptoms of both AD and DLB.

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“…Donepezil was used in three Alzheimer studies which looked at delusions as a separate outcome [22][23][24] . Two of these studies were open label in design [23,24] , and one used a double-blind, multi-centered, randomized, placebo-controlled design [22] .…”

Section: Cholinesterase Inhibitorsmentioning

confidence: 99%

“…Two of these studies were open label in design [23,24] , and one used a double-blind, multi-centered, randomized, placebo-controlled design [22] . The double-blind study was 24 weeks in duration and showed a significant improvement in delusional intensity compared to baseline.…”

Section: Cholinesterase Inhibitorsmentioning

confidence: 99%

Treatment of Delusions in Alzheimer’s Disease – Response to Pharmacotherapy

Fischer

Bozanovic

Atkins

et al. 2006

Dement Geriatr Cogn Disord

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Delusions are commonly encountered symptoms in patients with Alzheimer’s disease and may lead to significant morbidity. The purpose of this article is to review all clinical trials to date focusing on the management of delusions in patients with Alzheimer’s disease to determine the level of evidence for treatment. To achieve this objective, Medline was searched using the key words delusions, dementia, Alzheimer’s disease and psychosis. Three main categories of treatment were identified: atypical antipsychotics, cholinesterase inhibitors, and other miscellaneous treatments. It was concluded that all forms of treatment were effective although the greatest burden of evidence existed for risperidone and donepezil. Side effects were noted in all forms of treatment and included somnolence and extrapyramidal effects for antipsychotic medications, whereas gastrointestinal effects were more prevalent in studies involving cholinesterase inhibitors. Further large scale, double-blind, randomized, controlled studies are required before a definitive conclusion can be reached. To our knowledge this is the only systematic review of this area.

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Donepezil for the treatment of behavioral disturbances in Alzheimer's disease: a 6-month open trial

Cited by 27 publications

References 10 publications

Safety and Effectiveness of Donepezil on Behavioral Symptoms in Patients With Alzheimer Disease

Safety and Effectiveness of Donepezil on Behavioral Symptoms in Patients With Alzheimer Disease

Cognitive and Psychopathologic Response to Rivastigmine in Dementia With Lewy Bodies Compared to Alzheimer’s Disease: A Case Control Study

Treatment of Delusions in Alzheimer’s Disease – Response to Pharmacotherapy

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