PMID- 12139365
OWN - NLM
STAT- MEDLINE
DCOM- 20020912
LR  - 20181130
IS  - 1368-504X (Print)
IS  - 1368-504X (Linking)
IP  - 127
DP  - 2002 Jun
TI  - The efficacy of cholinesterase inhibitors in treating the behavioural symptoms of 
      dementia.
PG  - 20-36
AB  - Multiple behavioural and psychological symptoms of dementia (BPSD) are commonly 
      associated with all dementia subtypes, and worsen during disease progression. 
      BPSD arise due to impairment of cholinergic function in the cortex, hippocampus 
      and related limbic systems. Recent studies have investigated the effect of 
      cholinesterase inhibitors on BPSD. The dual 
      acetylcholinesterase/butyrylcholinesterase (AChE/BuChE) inhibitor rivastigmine 
      was shown to have several potential advantages over the AChE-selective inhibitors 
      donepezil and galantamine for the treatment of BPSD. Rivastigmine appears to be 
      effective across the range of dementia severity from mild to severe, and across 
      the spectrum of dementia (Alzheimer's disease [AD], the AD variant with Lewy 
      bodies, Parkinson's disease dementia and vascular dementia subtypes). It also 
      appears to have a disease-modifying potential. Rivastigmine improved a wider 
      range of behavioural symptoms (apathy, anxiety/depression, hallucinations and 
      delusions) than donepezil and galantamine (which improved apathy and 
      depression/anxiety only). Unlike donepezil, rivastigmine reduced the need for 
      psychotropic medications to treat BPSD. Dual inhibition of AChE and BuChE and 
      brain-region selectivity through preferential inhibition of the G1 isoform of 
      AChE may provide the underlying reasons for the apparently greater and broader 
      efficacy of rivastigmine over AChE-selective inhibitors for the treatment of 
      BPSD. However, randomised, controlled trials are required to compare dual 
      inhibitors, such as rivastigmine, and AChE-selective agents, to confirm and 
      quantify any differences in their effects on BPSD.
FAU - Rosler, M
AU  - Rosler M
AD  - Gerontopsychiatry Research Group, University of the Saarland, Homburg/Saar, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Int J Clin Pract Suppl
JT  - International journal of clinical practice. Supplement
JID - 9712380
RN  - 0 (Carbamates)
RN  - 0 (Cholinesterase Inhibitors)
RN  - 0 (Indans)
RN  - 0 (Nootropic Agents)
RN  - 0 (Phenylcarbamates)
RN  - 0 (Piperidines)
RN  - 0D3Q044KCA (Galantamine)
RN  - 8SSC91326P (Donepezil)
RN  - PKI06M3IW0 (Rivastigmine)
SB  - IM
MH  - Behavioral Symptoms/*drug therapy
MH  - Carbamates/therapeutic use
MH  - Cholinesterase Inhibitors/*therapeutic use
MH  - Dementia/*drug therapy/psychology
MH  - Donepezil
MH  - Galantamine/therapeutic use
MH  - Humans
MH  - Indans/therapeutic use
MH  - Nootropic Agents/*therapeutic use
MH  - *Phenylcarbamates
MH  - Piperidines/therapeutic use
MH  - Rivastigmine
MH  - Treatment Outcome
RF  - 132
EDAT- 2002/07/26 10:00
MHDA- 2002/09/13 10:01
CRDT- 2002/07/26 10:00
PHST- 2002/07/26 10:00 [pubmed]
PHST- 2002/09/13 10:01 [medline]
PHST- 2002/07/26 10:00 [entrez]
PST - ppublish
SO  - Int J Clin Pract Suppl. 2002 Jun;(127):20-36.