Pharmacological Therapy for Apathy in Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Sepehry, Amir Ali; Sarai, Michael; Hsiung, Ging-Yuek Robin

doi:10.1017/cjn.2016.426

Cited by 32 publications

(23 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A comprehensive meta-analysis of the reported pharmacological studies [ 42 ] provides little evidence for their effectiveness in treating apathy in AD, although it did not have access to the most recent methylphenidate data. The findings are likely to have been affected by the small number of studies, and heterogeneity in drugs, sample and apathy assessment.…”

Section: Treatmentmentioning

confidence: 99%

Apathy in Alzheimer's disease

Nobis

Husain

2018

Current Opinion in Behavioral Sciences

View full text Add to dashboard Cite

show abstract

Section: Treatmentmentioning

confidence: 99%

Apathy in Alzheimer's disease

Nobis

Husain

2018

Current Opinion in Behavioral Sciences

View full text Add to dashboard Cite

show abstract

“…reported in a post hoc analysis of a placebo-controlled RCT that apathy in patients with more severe AD was significantly improved after 24-week treatment of donepezil, as a secondary outcome [33]. Nonetheless, a meta-analysis revealed that pharmacological therapy using ChEI, memantine, and psycho-stimulants including methylphenidate had no significant effect on apathy [34].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Yokukansankachimpihange for Treating Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease: An Open-Label Pilot Study

Arita¹,

Yoshino²,

Ohgishi³

et al. 2018

AAD

View full text Add to dashboard Cite

Previous clinical trials have demonstrated the efficacy of yokukansan, a traditional Japanese medicine, for the treatment of behavioral and psychological symptoms of dementia (BPSD). However, less evidence is available for the treatment of BPSD with yokukansankachimpihange (YKSCH), which consists of yokukansan and two additional herbal ingredients. The present study was conducted to investigate the efficacy and safety of YKSCH for treating BPSD in patients with Alzheimer's disease (AD). We enrolled outpatients with mild-to-moderate AD who exhibited BPSD and obtained a Neuropsychiatric Inventory (NPI) score of >3 including subscale scores for "agitation", "anxiety", "irritability", and "sleep and night-time behavior change". A daily YKSCH dose of 7.5 g was administered for 12 weeks with concomitant administration of anti-dementia medication. BPSD was evaluated using the NPI at baseline and every 4 weeks during the intervention. We also examined apathy using the Japanese translation of the Apathy Scale, the short version of the Japanese version of the Zarit Caregiver Burden Interview, and the Modified Crichton Rating Scale for Predicting Activities of Daily Living. Cognitive dysfunction was evaluated using the Mini Mental State Examination and the AD Assessment Scale-Cognitive (Japanese version). Five participants were enrolled. The NPI total score tended to decrease between the baseline

show abstract

“…One recent article from January 2017 reviewed recent pharmacological and non-pharmacological approaches for the management of apathy in AD (Theleritis et al, 2017) and reported the potential interest of cholinesterase inhibitors (ChEIs), methylphenidate and gingko biloba in reducing levels of apathy, whereas Sepehry et al's review did not reveal any significant treatment effect likely to reduce apathy in AD (Sepehry et al, 2017). In Theleritis, among 6 studies using galantamine (4 RCT and 2 open-label studies), five studies did show an improvement of apathy levels after treatment.…”

Section: Reviews and Meta-analysesmentioning

confidence: 99%

Pharmacologic Approaches for the Management of Apathy in Neurodegenerative Disorders

et al. 2020

View full text Add to dashboard Cite

Apathy is one of the most frequent behavioral disturbances in many neurodegenerative disorders and is known to have a negative impact on the disease progression, particularly in Alzheimer's disease. Therapeutic options are currently limited and non-pharmacological approaches should constitute first line treatments. Pharmacological agents likely to reduce apathy levels are lacking. The objective of the present article is to review recent pharmacological treatments for apathy in neurodegenerative disorders. The Pubmed database was searched with a particular focus on articles published as of January 2017. Current main levels of evidence have been reported so far with cholinergic, glutamatergic and dopaminergic agents to reduce levels of apathy, despite several conflicting results. Treatment duration and samples sizes may have however decreased the validity of previous results. Ongoing studies involving more participants/treatment duration or distinct neural pathways may provide new insights in the treatment of apathy in neurodegenerative disorders.

show abstract

Pharmacological Therapy for Apathy in Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Abstract: The lack of an effect could be explained by methodological limitations, publication bias, and heterogeneity.

Cited by 32 publications

References 87 publications

Apathy in Alzheimer's disease

Apathy in Alzheimer's disease

The Efficacy and Safety of Yokukansankachimpihange for Treating Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease: An Open-Label Pilot Study

Pharmacologic Approaches for the Management of Apathy in Neurodegenerative Disorders

Contact Info

Product

Resources

About