[Cholinesterase inhibitors in Norway--effectiveness and side effects in clinical practice].
BACKGROUND
Naturalistic trials are needed to evaluate whether the results obtained in randomised trials of cholinesterase inhibitors (CEI) can be generalised to clinical practice. We conducted two studies in Norway to address this issue.


METHODS
We included patients with dementia from 16 centres in Norway who had received treatment with a CEI until November 2001 (study 1, n = 1,167, retrospective case review) or who came to the first evaluation after onset of treatment (study 2; n = 252; prospective enrollment). Adverse events, global effectiveness, and Mini-Mental State Exam scores were recorded.


RESULTS
In study 1, 56% of the patients were rated as mildly or markedly improved two to four months after onset of treatment. Side effects were recorded in 23%; 8% discontinued treatment due to side effects. In study 2, 49% were rated as mildly or markedly improved on at least one of the items cognition, psychiatric symptoms, activities of daily living or behaviour. Treatment was discontinued due to lack of effectiveness in 12%.


CONCLUSIONS
CEI were found to be useful in clinical practice in Norway. The open and uncontrolled design of the study limits the generalisability of the study.
Arsland
Dag
D
Alderspsykiatrisk seksjon, Psykiatrisk klinikk, Sentralsjukehuset i Rogaland, 4095 Stavanger, og, Psykiatrisk Institutt, Universitetet i Bergen. daa@post.rps.no
Engedal
Knut A
KA
Nygaard
Harald A
HA
Louhija
Jukka
J
Ulstein
Ingun
I
Holm
Marianne
M
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009664:Norway; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors