Nov 2001
international
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transplantation
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Nov 2001
international |
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LONG-TERM EFFICACY OF CHOLINESTERASE INHIBITORS
EFFICACY AND SAFETY OF DONEPEZIL IN MODERATE TO SEVERE STAGES OF AD
LONG-TERM USE OF RIVASTIGMINE IN DEMENTIA WITH LEWY BODIES
DIAGNOSTIC UNCERTAINTY in DEMENTIA WITH LEWY BODIES
FLUOXETINE FOR DEPRESSED AD PATIENTS
LINKS TO SUGGESTED ABSTRACTSLINKS TO SUGGESTED WEBSITES |
alzheimer's
issues: february 2003 november 2002 august 2002 may 2002 february 2002 november 2001 august 2001 may 2001 february 2001 november 2000 august 2000 june 2000 march 2000 november 1999 may 1999 february 1999 september 1998 june 1998 march 1998 december 1997 |
| EDITORIAL COMMENT |
LONG-TERM
EFFICACY OF |
Long-term efficacy and safety of donepezil in the treatment of Alzheimer's disease: final analysis of a US multicentre open-label study(EURO NEUROPSYCHOPHARMA 2000;10:195-203) |
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Galantamine in AD: A 6-month randomized, placebo-controlled trial with a 6-month extension(NEUROLOGY 2000;54:2261-2268) |
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A 52-week study of the efficacy of rivastigmine in patients with mild to moderately severe Alzheimer's disease(EUR NEUROL 2000;44-236-241) |
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MARTIN FARLOW, RAVI ANAND, JOHN MESSINA, JR, RICHARD HARTMAN, JEFFREY VEACH, INDIANAPOLIS, IN, EAST HANOVER, NJ |
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B. WINBLAD, MD, K. ENGEDAL, MD, H. SOININEN, MD, PHD, F. VERHEY, MD, ET AL, VARIOUS CENTRES, EUROPE, NEW YORK, NY |
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R.C. MOHS, PHD, R.S. DOODY, MD, PHD, J.C. MORRIS, MD, J.R. IENI, PHD, ET AL, NEW YORK, NY, HOUSTON, TX, ST. LOUIS, MO, TEANECK, NJ |
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Pharmacotherapy of Alzheimer's disease:
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BENGT WINBLAD, HENRY BRODATY, SERGE GAUTHIER, JOHN C. MORRIS, ET AL, VARIOUS CENTRES, EUROPE, VARIOUS CENTRES, NORTH AMERICA |
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| EDITORIAL COMMENT |
Evidence from pathological
studies has suggested that a cholinergic deficit was not present until late
in the disease (Davis et al, 1999). It was therefore logical to treat patients
in later stages, defined operationally as an MMSE score of 5 to 17, comparing
donepezil to placebo over six months (Feldman et al, 2001). The results
are very positive in terms of cognition, functional autonomy, behaviour
and global impression of change. Further studies are now under way in more
severe stages of AD defined as an MMSE score of less than 10.  |
Cholinergic markers in elderly patients with early signs of Alzheimer disease(JAMA 1999;281:1401-1406) |
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KENNETH L. DAVIS, MD, RICHARD C. MOHS, PHD, DEBORAH MARIN, MD, DUSHYANT P. PUROHIT, MD, ET AL, NEW YORK, NY |
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H. FELDMAN, MD, S. GAUTHIER, MD, J. HECKER, MD, B. VELLAS, MD, PHD, ET AL, VANCOUVER, BC, VERDUN, QC, TOULOUSE, FRANCE, NEW YORK, NY |
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| EDITORIAL COMMENT |
While there are several open long-term studies of the use of cholinesterase inhibitors for patients with Alzheimer's disease, little is known about their effect in dementia with Lewy bodies. In an open extension of a placebo-controlled RCT, Grace et al describe the use of rivastigmine in 29 patients with dementia with Lewy bodies over the course of 96 weeks. While these are only preliminary observations in a small sample, remarkably, cognitive and behavioural scores showed no statistically significant declines over this period of observation. Clearly, larger and more rigorous studies are needed to confirm these positive results. |
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DIAGNOSTIC UNCERTAINTY WITH DEMENTIA WITH LEWY BODIES |
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| EDITORIAL COMMENT |
A recent study by Londos
et al reminds us of the limitations of currently defined diagnostic criteria
for dementia with Lewy bodies. In this neuropathological study of patients
with clinically defined dementia with Lewy bodies or Alzheimer's disease,
significant overlap was noted in the pathology. The authors reported that
a substantial portion of patients diagnosed with dementia with Lewy bodies
had none of the characteristic pathology of the illness, but rather demonstrated
Alzheimer's disease pathology in combination with significant vascular frontal
white matter disease. This study should alert clinicians to consider a differential
diagnosis when presented with patients who meet the current consensus criteria
for this form of dementia. |
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E. LONDOS, U. PASSANT, L. GUSTAFSON, A. BRUN, LUND, SWEDEN |
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| EDITORIAL COMMENT |
Petracca et al have recently published the results of a double-blind,
placebo-controlled study of fluoxetine in depressed patients with Alzheimer's
disease. Results suggested that patients treated with either fluoxetine
or placebo improved significantly and equally over the six-week study.
The authors note that while similar negative results have been documented
with some antidepressants (e.g. imipramine) other studies have been positive
(e.g. clomipramine, citalopram, moclobemide). The compassionate care and
supportive environment fostered by the clinical trial setting likely accounts
for the positive results in the placebo group. This is an important message
for clinicians, but also for researchers, who must recognize these powerful
therapeutic effects when designing studies. |
A double-blind, placebo-controlled study of fluoxetine in depressed patients with Alzheimer's disease(INT PSYCHOGERIATRICS 2001;13:233-240) |
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GUSTAVO M. PETRACCA, ERAN CHEMERINSKI, SERGIO E. STARKSTEON, BUENOS AIRES, ARGENTINA |
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| ABSTRACTS |
THE FOLLOWING PAPERS and websites were judged by the editors to also be of interest. THE CORTICOBASAL DEGENERATION SYNDROME OVERLAPS PROGRESSIVE APHASIA AND FRONTOTEMPORAL DEMENTIA DEMENTIA WITH PROMINENT FRONTOTEMPORAL FEATURES ASSOCIATED WITH L113P PRESENILIN I MUTATION
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