title: Rivastigmine in vascular dementia.
abstract: Patients with vascular dementia (VaD) show cholinergic deficits that may result in characteristic clinical syndromes for different subtypes of the condition. Subcortical VaD is characterised by executive dysfunction and behavioural problems, reflecting deterioration of the frontal lobe. Based on limited open-labelled controlled studies of rivastigmine in VaD, this article aims to determine whether rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), has any effects on the typical symptoms of subcortical VaD. Long-term rivastigmine treatment is safe and effective. Improvements in domains that characterise subcortical VaD were observed, indicating that rivastigmine may have provided targeted treatment in areas of the brain that are particularly affected in this patient population. A large, double-blind study of rivastigmine in patients with VaD is clearly warranted.
authors.affiliation: Università degli Studi di Trieste, Istituto di Clinica Neurologica, Ospedale di Cattinara, 34149 Trieste, Italy. moretti@univ.trieste.it
authors.forename: Rita
authors.initials: R
authors.lastname: Moretti
authors.forename: Paola
authors.initials: P
authors.lastname: Torre
authors.forename: Rodolfo M
authors.initials: RM
authors.lastname: Antonello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cazzato
authors.forename: Antonio
authors.initials: A
authors.lastname: Bava
mesh_terms: D000110:Acetylcholinesterase / Q000378:metabolism; D002091:Butyrylcholinesterase / Q000378:metabolism; D002219:Carbamates / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015140:Dementia, Vascular / Q000188:drug therapy*; D004347:Drug Interactions; D006801:Humans; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D048448:Phenylcarbamates; D000068836:Rivastigmine
chemical_list: D002219:Carbamates; D002800:Cholinesterase Inhibitors; D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000110:Acetylcholinesterase; D002091:Butyrylcholinesterase; D000068836:Rivastigmine