Neuroscience
Cummings JL, McRae T, & Zhang R. (2006). Effects of donepezil on neuropsychiatric symptoms in patients with dementia and severe behavioral disorders. American Journal of Geriatric Psychiatry, 14(7), 605-612.
Departments of Neurology and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California (JLC); and Pfizer, Inc., New York, New York (TM, RZ).
Objective: The objective of this study was to conduct exploratory analyses of data pertaining to the efficacy of donepezil treatment of patients with severe behavioral disturbances. Preliminary studies suggest that cholinesterase inhibitors, including donepezil, may reduce behavioral disturbances in patients with Alzheimer disease (AD). Most patients included in clinical trials have had low levels of psychopathology at baseline, and the effect of cholinesterase inhibitors on patients with more severe behavioral disturbances is unknown. The authors report the effects of donepezil on behavioral disturbances in patients with relatively severe psychopathology at baseline. Methods: This is a hypothesis-driven secondary analysis of a three-phase study involving donepezil and sertraline. In phase 1, psychotropic agents were withdrawn; in phase 2, patients were treated in an open-label fashion with donepezil for 8 weeks; and in phase 3, patients on donepezil were randomized to receive placebo or sertraline for an additional 12 weeks. The data set analyzed is comprised of the patient population treated with donepezil (without sertraline) for 20 weeks. One hundred twenty patients were included in the analyses. Mean age was 76 years, average Mini-Mental State Examination Score was 18, and mean Neuropsychiatric Inventory (NPI) total score was 30. Primary efficacy assessments were the NPI, the Clinical Global Impression-Improvement, and the Clinical Global Impression-Severity scales. Secondary measures included the Behavioral Pathology in Alzheimer's Disease Rating Scale, The Hamilton Depression Rating Scale, and the Alzheimer's Disease Functional Assessment and Change Scale. Results: Excellent concurrent validity was noted between the NPI and the Behavioral Pathology in Alzheimer's Disease Rating Scale. The total score of the NPI was significantly reduced over the 20 weeks of therapy with donepezil. Sixty-two percent of patients had at least a 30% reduction in the total NPI score (significantly greater than the number with no meaningful response). Likewise, more patients had total or partial resolution of depression and delusions than those who had no meaningful change. Factor analysis of baseline NPI data revealed five factors, including a psychosis factor, an agitation factor, mood factor, frontal lobe function factor, and appetite and eating disorders factor. Clinically meaningful treatment effect sizes were notable for the delusion factor (0.340) and the mood factor (0.39). There were significant correlations between the Clinical Global Impression-Improvement and reductions in mood and agitation scores. Conclusion: The results of these analyses suggest that donepezil reduces behavioral symptoms, particularly mood disturbances and delusions, in patients with AD with relatively severe psychopathology.
PMID: 16816014 [PubMed - in process]
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Anthony H. Risser | neuroscience | neuropsychology | brain
- Alzheimer Disease: Targacept's Failed Tc-1734 Phase 2b Trial
From a Targacept press release:Targacept Phase 2b Clinical Trial in Alzheimer’s Disease Does Not Show Superiority of TC-1734 Over Donepezil July 14, 2014 "Winston-Salem, NC – Targacept, Inc. (NASDAQ: TRGT), a clinical-stage biopharmaceutical company...
- Neuropsychology Abstract Of The Day: Donepezil And Aphasia
Chen Y, Li YS, Wang ZY, Xu Q, Shi GW, & Lin Y. [The efficacy of donepezil for post-stroke aphasia: a pilot case control study.] Zhonghua Nei Ke Za Zhi. 2010 Feb, 49(2), 115-118. OBJECTIVE: To evaluate the efficacy of donepezil for post-stroke aphasia....
- Neuropsychology Abstract Of The Day: Donepezil, Mci, And Ad
Lu PH, Edland SD, Teng E, Tingus K, Petersen RC, Cummings JL & Alzheimer's Disease Cooperative Study Group. (2009) Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology, 72(24):, 2115-2121. Departments of Neurology,...
- Abstract Of The Day: Alzheimer Disease Drug Treatments
Birks J. Cholinesterase inhibitors for Alzheimer's disease. Cochrane Database Syst Rev. 2006 Jan 25; (1): CD005593. BACKGROUND: Since the introduction of the first cholinesterase inhibitor (ChEI) in 1997, most clinicians and probably most patients...
- Abstract Of The Day: Donepezil (aricept) And Alzheimer Disease
Csernansky JG, Wang L, Miller JP, Galvin JE, & Morris JC. Neuroanatomical predictors of response to donepezil therapy in patients with dementia. Archives of Neurology. 2005 Nov; 62(11): 1718-1722. Alzheimer's Disease Research Center, and Department...
Neuroscience
Abstract of the Day: Alzheimer Disease
Cummings JL, McRae T, & Zhang R. (2006). Effects of donepezil on neuropsychiatric symptoms in patients with dementia and severe behavioral disorders. American Journal of Geriatric Psychiatry, 14(7), 605-612.
Departments of Neurology and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California (JLC); and Pfizer, Inc., New York, New York (TM, RZ).
Objective: The objective of this study was to conduct exploratory analyses of data pertaining to the efficacy of donepezil treatment of patients with severe behavioral disturbances. Preliminary studies suggest that cholinesterase inhibitors, including donepezil, may reduce behavioral disturbances in patients with Alzheimer disease (AD). Most patients included in clinical trials have had low levels of psychopathology at baseline, and the effect of cholinesterase inhibitors on patients with more severe behavioral disturbances is unknown. The authors report the effects of donepezil on behavioral disturbances in patients with relatively severe psychopathology at baseline. Methods: This is a hypothesis-driven secondary analysis of a three-phase study involving donepezil and sertraline. In phase 1, psychotropic agents were withdrawn; in phase 2, patients were treated in an open-label fashion with donepezil for 8 weeks; and in phase 3, patients on donepezil were randomized to receive placebo or sertraline for an additional 12 weeks. The data set analyzed is comprised of the patient population treated with donepezil (without sertraline) for 20 weeks. One hundred twenty patients were included in the analyses. Mean age was 76 years, average Mini-Mental State Examination Score was 18, and mean Neuropsychiatric Inventory (NPI) total score was 30. Primary efficacy assessments were the NPI, the Clinical Global Impression-Improvement, and the Clinical Global Impression-Severity scales. Secondary measures included the Behavioral Pathology in Alzheimer's Disease Rating Scale, The Hamilton Depression Rating Scale, and the Alzheimer's Disease Functional Assessment and Change Scale. Results: Excellent concurrent validity was noted between the NPI and the Behavioral Pathology in Alzheimer's Disease Rating Scale. The total score of the NPI was significantly reduced over the 20 weeks of therapy with donepezil. Sixty-two percent of patients had at least a 30% reduction in the total NPI score (significantly greater than the number with no meaningful response). Likewise, more patients had total or partial resolution of depression and delusions than those who had no meaningful change. Factor analysis of baseline NPI data revealed five factors, including a psychosis factor, an agitation factor, mood factor, frontal lobe function factor, and appetite and eating disorders factor. Clinically meaningful treatment effect sizes were notable for the delusion factor (0.340) and the mood factor (0.39). There were significant correlations between the Clinical Global Impression-Improvement and reductions in mood and agitation scores. Conclusion: The results of these analyses suggest that donepezil reduces behavioral symptoms, particularly mood disturbances and delusions, in patients with AD with relatively severe psychopathology.
PMID: 16816014 [PubMed - in process]
-
Anthony H. Risser | neuroscience | neuropsychology | brain
- Alzheimer Disease: Targacept's Failed Tc-1734 Phase 2b Trial
From a Targacept press release:Targacept Phase 2b Clinical Trial in Alzheimer’s Disease Does Not Show Superiority of TC-1734 Over Donepezil July 14, 2014 "Winston-Salem, NC – Targacept, Inc. (NASDAQ: TRGT), a clinical-stage biopharmaceutical company...
- Neuropsychology Abstract Of The Day: Donepezil And Aphasia
Chen Y, Li YS, Wang ZY, Xu Q, Shi GW, & Lin Y. [The efficacy of donepezil for post-stroke aphasia: a pilot case control study.] Zhonghua Nei Ke Za Zhi. 2010 Feb, 49(2), 115-118. OBJECTIVE: To evaluate the efficacy of donepezil for post-stroke aphasia....
- Neuropsychology Abstract Of The Day: Donepezil, Mci, And Ad
Lu PH, Edland SD, Teng E, Tingus K, Petersen RC, Cummings JL & Alzheimer's Disease Cooperative Study Group. (2009) Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology, 72(24):, 2115-2121. Departments of Neurology,...
- Abstract Of The Day: Alzheimer Disease Drug Treatments
Birks J. Cholinesterase inhibitors for Alzheimer's disease. Cochrane Database Syst Rev. 2006 Jan 25; (1): CD005593. BACKGROUND: Since the introduction of the first cholinesterase inhibitor (ChEI) in 1997, most clinicians and probably most patients...
- Abstract Of The Day: Donepezil (aricept) And Alzheimer Disease
Csernansky JG, Wang L, Miller JP, Galvin JE, & Morris JC. Neuroanatomical predictors of response to donepezil therapy in patients with dementia. Archives of Neurology. 2005 Nov; 62(11): 1718-1722. Alzheimer's Disease Research Center, and Department...