title: Effect of donepezil in patients with Alzheimer's disease previously untreated or treated with memantine or nootropic agents in Germany: an observational study.
abstract: OBJECTIVE
  This open-label, prospective, observational, Post-Marketing Surveillance (PMS) study assessed the efficacy and safety of donepezil in patients who had been switched from therapies currently used in Germany to treat Alzheimer's disease (AD), such as memantine and nootropics, due to insufficient efficacy or poor tolerability. A treatment-naive population was included as a comparator.
  
  
  METHODS
  Patients with AD were treated with donepezil and observed for a period of approximately 3 months. A cognitive assessment was made using the Mini-Mental State Examination (MMSE). Quality of life (QoL) was assessed by the investigators who answered the question 'How did therapy with donepezil influence the QoL of the patient and/or his family over the observation period?' and was graded using three ratings: improved/unchanged/worsened. Adverse events (AEs) were also monitored.
  
  
  RESULTS
  A total of 913 patients entered the study (mean +/- SD MMSE score 18.03 +/- 5.34). Efficacy assessments were analyzed for three groups: an overall group of patients who had received any form of prior AD drug therapy (N+ group; n = 709); a subgroup of patients from the N+ group who had received prior memantine therapy only (M+ group; n = 111) and patients who were drug treatment naive (N- group; n = 204). In the evaluable population donepezil improved MMSE scores by 2.21 +/- 3.47 points on average, with similar improvements observed in all three groups. QoL was judged to be improved in at least 70% of patients, again with similar results obtained for all three groups. Donepezil was well tolerated, with 85 of 913 (9.3%) patients reporting AEs. The most common AEs were those typically seen with cholinergic therapies (i.e., diarrhoea, vomiting and nausea).
  
  
  CONCLUSIONS
  In this observational PMS study, donepezil was shown to be efficacious and well tolerated in patients who were being insufficiently treated with memantine or nootropic therapy. The magnitude of response was similar to that observed in patients who were previously treatment naive, suggesting prior medication does not effect donepezil's efficacy.
authors.affiliation: Staedt. Klinikum St. Georg, Verbund Gemeindenahe Psychiatrie West/Suedwest, Leipzig, Germany.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Klinger
authors.forename: Bernd
authors.initials: B
authors.lastname: Ibach
authors.forename: Peter
authors.initials: P
authors.lastname: Schoenknecht
authors.forename: Martin
authors.initials: M
authors.lastname: Kamleiter
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Silver
authors.forename: Johannes
authors.initials: J
authors.lastname: Schroeder
authors.forename: Ruediger
authors.initials: R
authors.lastname: Mielke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000201:enzymology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D000077265:Donepezil; D005260:Female; D005858:Germany; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D019370:Observation; D010880:Piperidines / Q000627:therapeutic use*; D011358:Product Surveillance, Postmarketing; D011446:Prospective Studies; D011788:Quality of Life; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D016194:Receptors, N-Methyl-D-Aspartate; D000077265:Donepezil; D008559:Memantine