[Tolerance and adverse events of treatment with acetylcholinesterase inhibitors in a clinical sample of patients with very slight and mild Alzheimer s disease over a six-month period].
BACKGROUND
At present acetylcholinesterase inhibitors (AChEI) are used in the treatment of the cognitive deterioration associated with Alzheimer s disease (AD). The side effects of these drugs are linked with the increase in acetylcholine, which limits their effectiveness, and must be adjusted to the patient close to the maximum tolerated dose.


METHODS
We conducted a comparative retrospective study of the tolerance and the adverse events (AE) of two AChEI in a group of patients with very slight and mild probable AD over a 6 month period.


RESULTS
The sample was made up of 175 patients, of which 134 began therapy with 5 10 mg/day of donepezil and 41 with 6 12 mg/day of rivastigmine. 20% of the patients presented AE and 8% abandoned the treatment. Gastrointestinal disorders (GID) were the main AE observed (57.1%). Only 6% of the patients treated with donepezil abandoned the therapy because of the AE as opposed to 14.6% of the patients treated with rivastigmine. Patients treated with rivastigmine displayed a higher incidence of GID and the relative risk of presenting GID was 4.4 times higher than in the patients treated with donepezil.


CONCLUSIONS
The GID associated to therapy with AChEI are the main reason for abandoning treatment and occur more frequently in patients treated with rivastigmine.
Turon-Estrada
A
A
Unitat de Valoració de la Memòria i les Demències (UVAMID), Hospital Santa Caterina, Girona, España. uvamid@yahoo.es
López-Pousa
S
S
Gelada-Batlle
E
E
Garre-Olmo
J
J
Lozano-Gallego
M
M
Hernández-Ferràndiz
M
M
Fajardo-Tibau
C
C
Morante-Muñoz
V
V
Vilalta-Franch
J
J
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy*; D002219:Carbamates / Q000009:adverse effects* / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000077265:Donepezil; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007189:Indans / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D048448:Phenylcarbamates; D010880:Piperidines / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D000068836:Rivastigmine
D002219:Carbamates; D002800:Cholinesterase Inhibitors; D007189:Indans; D048448:Phenylcarbamates; D010880:Piperidines; D000077265:Donepezil; D000068836:Rivastigmine