The aim of this study was to investigate the efficacy of
nootropics (
piracetam,
aniracetam, nimodopine and dihydroergicristine) versus
acetylcholinesterase inhibitors (AChE-Is) (
tacrine and
donepezil) in the treatment of
Alzheimer's disease. This is a retrospective study of 510 patients with
Alzheimer's disease. To determine clinical efficacy of treatment, we used the mean change over time in scores for the following tests: the Mini-Mental State Examination (MMSE); the Cambridge Cognitive Examination for the Elderly; and the Functional Rating Scale for Symptoms of
Dementia. In all patients and in patients with severe
Alzheimer's disease (baseline MMSE < 11), no significant differences were seen in the neuropsychological test scores between the two treatment groups. In patients with moderate
dementia (baseline MMSE between 11 and 20), however, there was a significantly greater deterioration, as shown on the CAMCOG scale, after 12 months' treatment for patients receiving AChE-Is compared with those receiving
nootropics (-4.38 for AChE-Is group versus 1.48 for
nootropics group). For patients with mild
dementia (baseline MMSE score between 21 and 26), there was a significantly greater deterioration on the MMSE scale for each time-point in the
nootropics group compared with the AChE-Is group. In conclusion, we did not find any strong evidence that a difference in efficacy exists between AChE-Is and
nootropics in the treatment of
Alzheimer's disease.