Neuroscience
Howard RJ, Juszczak E, Ballard CG, Bentham P, Brown RG, Bullock R, Burns AS, Holmes C, Jacoby R, Johnson T, Knapp M, Lindesay J, O'Brien JT, Wilcock G, Katona C, Jones RW, DeCesare J, Rodger M; CALM-AD Trial Group. Donepezil for the treatment of agitation in Alzheimer's disease. New England Journal of Medicine. 2007 Oct 4; 357(14): 1382-1392.
Medical Research Council Neurogeneration Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom.
BACKGROUND: Agitation is a common and distressing symptom in patients with Alzheimer's disease. Cholinesterase inhibitors improve cognitive outcomes in such patients, but the benefits of these drugs for behavioral disturbances are unclear. METHODS: We randomly assigned 272 patients with Alzheimer's disease who had clinically significant agitation and no response to a brief psychosocial treatment program to receive 10 mg of donepezil per day (128 patients) or placebo (131 patients) for 12 weeks. The primary outcome was a change in the score on the Cohen-Mansfield Agitation Inventory (CMAI) (on a scale of 29 to 203, with higher scores indicating more agitation) at 12 weeks. RESULTS: There was no significant difference between the effects of donepezil and those of placebo on the basis of the change in CMAI scores from baseline to 12 weeks (estimated mean difference in change [the value for donepezil minus that for placebo], -0.06; 95% confidence interval [CI], -4.35 to 4.22). Twenty-two of 108 patients (20.4%) in the placebo group and 22 of 113 (19.5%) in the donepezil group had a reduction of 30% or greater in the CMAI score (the value for donepezil minus that for placebo, -0.9 percentage point; 95% CI, -11.4 to 9.6). There were also no significant differences between the placebo and donepezil groups in scores for the Neuropsychiatric Inventory, the Neuropsychiatric Inventory Caregiver Distress Scale, or the Clinician's Global Impression of Change. CONCLUSIONS: In this 12-week trial, donepezil was not more effective than placebo in treating agitation in patients with Alzheimer's disease. (ClinicalTrials.gov number, NCT00142324 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.
PMID: 17914039 [PubMed - indexed for MEDLINE]
Comment in: New England Journal of Medicine. 2007 Oct 4; 357(14): 1441-1443.
- 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...
- Donepezil, Vitamin E, And Mild Cognitive Impairment In Aging
The New England Journal of Medicine has made available on its website prepublication versions of the results of a large study relevant to aging, neuropsychological changes in aging, and the onset of dementia. It has also made available in the same format...
Neuroscience
Neuropsychology Abstract of the Day: Agitation in Alzheimer's Disease (AD)
Howard RJ, Juszczak E, Ballard CG, Bentham P, Brown RG, Bullock R, Burns AS, Holmes C, Jacoby R, Johnson T, Knapp M, Lindesay J, O'Brien JT, Wilcock G, Katona C, Jones RW, DeCesare J, Rodger M; CALM-AD Trial Group. Donepezil for the treatment of agitation in Alzheimer's disease. New England Journal of Medicine. 2007 Oct 4; 357(14): 1382-1392.
Medical Research Council Neurogeneration Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom.
BACKGROUND: Agitation is a common and distressing symptom in patients with Alzheimer's disease. Cholinesterase inhibitors improve cognitive outcomes in such patients, but the benefits of these drugs for behavioral disturbances are unclear. METHODS: We randomly assigned 272 patients with Alzheimer's disease who had clinically significant agitation and no response to a brief psychosocial treatment program to receive 10 mg of donepezil per day (128 patients) or placebo (131 patients) for 12 weeks. The primary outcome was a change in the score on the Cohen-Mansfield Agitation Inventory (CMAI) (on a scale of 29 to 203, with higher scores indicating more agitation) at 12 weeks. RESULTS: There was no significant difference between the effects of donepezil and those of placebo on the basis of the change in CMAI scores from baseline to 12 weeks (estimated mean difference in change [the value for donepezil minus that for placebo], -0.06; 95% confidence interval [CI], -4.35 to 4.22). Twenty-two of 108 patients (20.4%) in the placebo group and 22 of 113 (19.5%) in the donepezil group had a reduction of 30% or greater in the CMAI score (the value for donepezil minus that for placebo, -0.9 percentage point; 95% CI, -11.4 to 9.6). There were also no significant differences between the placebo and donepezil groups in scores for the Neuropsychiatric Inventory, the Neuropsychiatric Inventory Caregiver Distress Scale, or the Clinician's Global Impression of Change. CONCLUSIONS: In this 12-week trial, donepezil was not more effective than placebo in treating agitation in patients with Alzheimer's disease. (ClinicalTrials.gov number, NCT00142324 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.
PMID: 17914039 [PubMed - indexed for MEDLINE]
Comment in: New England Journal of Medicine. 2007 Oct 4; 357(14): 1441-1443.
- 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...
- Donepezil, Vitamin E, And Mild Cognitive Impairment In Aging
The New England Journal of Medicine has made available on its website prepublication versions of the results of a large study relevant to aging, neuropsychological changes in aging, and the onset of dementia. It has also made available in the same format...