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It is still unclear how effective the
cholinesterase inhibitors (ChEIs) are for treating the neuropsychiatric
symptoms (NPS) of Alzheimer’s disease given that most of
the data comes from the pivotal ChEIs studies which included
only mildly behaviourally disturbed patients (see for example
Trinh et al, JAMA 2005). Cummings et al (2006) report on a secondary
analysis of a study which examined the effects of sertraline
and donepezil, or placebo and donepezil on patients pre-treated
with donepezil, who had moderately severe NPS. Most patients
experienced significant reductions in NPS especially for scores
on delusions and depressive symptoms.
Effects of donepezil on neuropsychiatric
symptoms in patients with dementia and severe behavioral disorders
(AM J GERIATR PSYCHIATRY 2006;14:605-612)
JEFFREY L. CUMMINGS, MD,
THOMAS MCRAE, MD,
RICHARD ZHANG, PhD
new york, ny,
los angeles, CA
THE DONEPEZIL-SERTRALINE
STUDY GROUP
VAGUS NERVE STIMULATION AND
AD
Vagus nerve stimulation (VNS) via an implanted
“pacemaker-like” device is approved for the treatment
of epilepsy, and has more recently been investigated as treatment
for refractory depression. Based on research which suggests
VNS increases activity in noradrenergic and serotoninergic brain
regions, Merrill et al (2006) studied VNS in 17 AD patients.
There was evidence of improvement and/or stabilization of cognitive,
global, and behavioural measures over the course of one year.
While these results are intriguing, such an invasive therapy
might be reasonably expected to have significant placebo effects.
Randomized controlled trials are therefore warranted to better
characterize the efficacy and safety of this non-pharmacological
treatment approach.
Vagus nerve stimulation in patients
with Alzheimer’s disease: additional follow-up results
of a pilot study through 1 year
(J CLIN PSYCHIATRY 2006 67:1171-1178)
CHARLEY A. MERRILL, PhD,
MICHAEL A.G. JONSSON, MD,
LENNART MINThON, MD,
PhD,
HASSE EJNELL, MD, PhD,
ET AL,
Jersey city, nj
malmö, göteborg, sweden
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