Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease

Leroi, Iracema; Brandt, Jason; Reich, Stephen G.; Lyketsos, Constantine G.; Grill, Stephen; Thompson, Richard E.; Marsh, Laura

doi:10.1002/gps.993

Cited by 187 publications

(148 citation statements)

References 36 publications

(42 reference statements)

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“…However, data from clinical trials of anti-dementia agents in the PD setting have been mixed, with some studies reporting a decrease in hallucinations, 28,29 and others reporting no improvement in neuropsychiatric symptoms. [30][31][32] We also observed, from our weighted analysis, that an estimated 16% of patients receiving treatment for PDP have been prescribed risperidone at some point during their course of care. The observation is a potential point of concern in the clinical management of PDP because risperidone is known to exacerbate PD motor symptoms, increase mortality risk in elderly patients with dementia (a common comorbidity among patients with PD), has known interactions with other atypical antipsychotics and is generally not recommended for use in patients with PD.…”

Section: Discussionsupporting

confidence: 52%

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Cook¹,

Suresh²,

Lou³

et al. 2017

European Neurological Review

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Over half of patients with Parkinson’s disease (PD) develop symptoms of psychosis during the course of their disease. Existing guidelines include recommendations for managing symptoms of psychosis in patients with PD. However, the extent to which such recommendations translate to clinical practice in major European nations is unclear. The current study describes trends in the clinical management of patients diagnosed with PD psychosis (PDP) based on survey responses and patient chart reviews from 437 neurologists across France, Germany, Italy, Spain, and the UK (collectively, the EU-5). Surveyed neurologists reported that PDP typically manifests four or more years after the diagnosis of PD, with the most commonly reported initial symptoms being moderately disruptive visual hallucinations, agitation, and illusions/false sense of presence. PD medications adjustment was the most common first-line intervention, applicable to an estimated 59–79% of patients for the initial management of PDP depending on country. Responses from surveyed neurologists suggest PD medications adjustment is a temporary solution for many patients with PDP and that there is considerable variability in subsequent lines of intervention. The current report provides a resource for understanding the patterns of care and treatment for PDP across these major European nations.

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Section: Discussionsupporting

confidence: 52%

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Cook¹,

Suresh²,

Lou³

et al. 2017

European Neurological Review

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“…Hallucinations improved in seven of nine patients. Parkinsonism improved in six individuals, but a slight worsening of tremor was observed in three (Leroi et al, 2004). In another randomized, doubleblind and placebo-controlled study, which involved 16 patients, donepezil improved significantly the subscales of memory.…”

Section: Pd Dementia X Dementia In Normal Pressurementioning

confidence: 90%

Dementia in Parkinson's Disease: A Clinical Review

Vieira¹,

Caixeta²,

Machado³

et al. 2011

American Journal of Neuroscience

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Problem statement: Idiopathic Parkinson's Disease (PD) has being increasingly seen as a neuropsychiatric entity and no longer purely neurological, given the frequency and exuberance with which the psychiatric manifestations occurs. Approach: This review will focus on the epidemiology, clinical aspects, differential diagnosis with Alzheimer's Disease (AD) associated with parkinsonism, Dementia with Lewy Bodies (LBD), Progressive Supranuclear Palsy (PSP), Corticobasal Degeneration (CBD), Multiple System Atrophy (MSA), Vascular Parkinsonism and normal pressure hydrocephalus (NPN), underlying mechanisms and treatment of dementia in PD. A literature review of the studies that investigated the dementia in PD was performed. Results: The dementia in PD has being increasingly recognized as a distinct nosological entity. Although specific etiologies for cognitive impairment remain unknown, a symptomatic treatment has been approved and strategies for early intervention are envisioned. Conclusion: Larger scale, placebo controlled clinical trials are needed to be explored in future studies to provide an evidence base to guide the management in dementia associated with PD.

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“…Though, applications of most of the drugs are still debated. However, the efficacies of the drugs like Donepezil, Atomoxetine, and Citicoline cannot be ruled out owing to their promises [43]. Earlier it was believed that, the occurrence of cognitive impairment in PD is limited to mid-to-late stage of the disease progress but, recent progress of research have showed that, mild cognitive changes is quite common in early stages of PD and hence, opening an avenue of research scope for early diagnosis of the disease.…”

Section: Reviewmentioning

confidence: 99%

Cognitive and Psychological Anomalies in Parkinsons Disease: An Insight into Non-Motor Characteristic Features

Choudhury¹,

Rao²,

R³

et al. 2017

Neuropsychiatry

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While most of the clinical concerns for Parkinson's disease (PD) are limited to the cardinal motor abnormalities, non-motor features like cognitive and psychological anomalies are also acquired ample of importance in last few decades. Progressive research has showcased several obvious incidences of cognitive and psychological anomalies in the pathophysiology of PD. It has been reported that, almost 30% PD sufferers show different degree of cognitive impairment but lack of awareness or negligence makes it difficult to diagnose it, at the initial stage of the disease. As a result, cognitive and psychological impairments continue to increases progressively and deteriorate the quality of life of the patient. It is presumable that, early detection of PD can be achieved by the identification of specific set of cognitive and psychological anomalies and the similar scope might open up new avenue in the non-invasive diagnosis of PD. In the present review, we have accumulated all the timely documentation on cognitive and psychological anomalies in PD and highlighted most of the non-motor features with rational justification for the relevance of their study in the early diagnosis of PD.

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Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease

Cited by 187 publications

References 36 publications

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Dementia in Parkinson's Disease: A Clinical Review

Cognitive and Psychological Anomalies in Parkinsons Disease: An Insight into Non-Motor Characteristic Features

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