Abstract | BACKGROUND: REVIEW SUMMARY: Effective therapy requires up-titration from initial dosage of 3 mg/d to 6 mg/d with additional increases to 9 mg or 12 mg/d giving additional benefits in some patients. Beneficial effects with rivastigmine therapy in the functioning of activities of daily living, behavior, cognition, and global functioning have been demonstrated in patients with mild to moderate Alzheimer disease in 4 large double-blind, placebo-controlled multicenter clinical trials. Potential adverse effects of nausea, vomiting, or diarrhea in these original Alzheimer trials with rapid (every week) dosage increases occurred in up to 34% of patients and can be minimized by slower monthly up-titrations. Rivastigmine also was proven effective in decreasing psychiatric symptoms and cognitive deficits in a large double-blind, placebo-controlled trial in patients with diffuse Lewy body disease. Other studies have suggested that rivastigmine improves symptoms in nursing home patients with more severe stage Alzheimer disease, Parkinson dementia, and subcortical dementia. Follow-up studies have suggested that rivastigmine may delay disease progression and, in patients discontinuing the drug, no withdrawal effects were seen. CONCLUSION:
|
Authors | Martin R Farlow |
Journal | The neurologist
(Neurologist)
Vol. 9
Issue 5
Pg. 230-4
(Sep 2003)
ISSN: 1074-7931 [Print] United States |
PMID | 14587496
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
|
Chemical References |
- Carbamates
- Cholinesterase Inhibitors
- Phenylcarbamates
- Rivastigmine
|
Topics |
- Alzheimer Disease
(drug therapy)
- Animals
- Carbamates
(adverse effects, pharmacokinetics, therapeutic use)
- Cholinesterase Inhibitors
(adverse effects, pharmacokinetics, therapeutic use)
- Humans
- Phenylcarbamates
- Rivastigmine
|