AD Lib

ID: 10321
Title:Cholinesterase Inhibitors for Alzheimer's Disease. (Cochrane Review).
Publication Year: 2006
Format(s): Journal Article , Review
Language(s): English
Audience(s): Physicians , Psychiatrists , Neurologists , Geriatricians
Author(s): Birks, J.
Source: Cochrane Database of Systematic Reviews. Issue 1: 1-75. Art. No. CD005593. January 25, 2006.

Abstract: This monograph presents a review of the research literature on the effects of cholinesterase inhibitors (ChEIs) donepezil, galantamine, and rivastigmine in people with Alzheimer’s disease (AD). These drugs have slightly different pharmacological properties, but they all work by inhibiting the breakdown of acetylcholine, an important neurotransmitter associated with memory, by blocking the enzyme acetylcholinesterase. The review included all unconfounded, blinded, randomized trials of at least 6 months in which treatment with a ChEI at the usual recommended dose was compared with placebo or another ChEI for patients with mild, moderate, or severe dementia due to AD. Data were extracted, pooled where appropriate and possible, and the pooled treatment effects or the risks and benefits of treatment were estimated. The results indicate that treatment with donepezil, galantamine, or rivastigmine at the recommended dose produced improvements in cognitive function, on average –2.7 points in the midrange of the 70-point ADAS-Cog (Alzheimer's disease assessment) scale. Benefits were also seen in clinician-rated global assessments and measures of activities of daily living and behavior. None of the treatment effects were large. Patients receiving a ChEI experienced more adverse events than those receiving placebo. There was no evidence of differences in efficacy between the three drugs, although one trial showed fewer adverse events with donepezil compared with rivastigmine.

Availability: Available from Cochrane Library at Wiley Interscience, John Wiley and Sons, Inc. E-Business Dept., 8th floor, 111 River Street, Hoboken, NJ 07030-5774. (866) 465-3817; FAX: (201) 784-5715. E-mail: emrworders@wiley.com. Website: www3.interscience.wiley.com. PRICE:$25.00 FOR 24-hour online access; $265.00 individual annual subscription; $495.00 institutional annual subscription (price varies on type of institution, user population, and format selected.
Major Descriptor(s): ALZHEIMERS-DISEASE , GALANTAMINE , CHOLINESTERASE-INHIBITORS , DONEPEZIL , RIVASTIGMINE , DRUG-EVALUATION , DRUG-EFFECTS , LITERATURE-REVIEWS , CLINICAL-TRIALS
Minor Descriptor(s): ADVERSE-EFFECTS , COMPARATIVE-ANALYSIS

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