Drug prescription in mild cognitive impairment: the physicians' perspective in Italy.
OBJECTIVE
Today there are no data on the type of drugs prescribed to MCI patients nor the prevalence of their prescription. The aim of this study was to describe which drugs were prescribed in 2004 for cognitive and non cognitive disturbances of patients with MCI in a sizable group of Italian expert centers for the diagnosis and treatment of Alzheimer's disease.


METHODS
Eighty-eight of the 314 contacted UVAs (28%) agreed to take part to the present study. The physicians were surveyed with a structured questionnaire assessing questions related to prescription of drug therapy based on their subjective judgement.


RESULTS
Cholinesterase inhibitors are prescribed to 90% of patients with AD but, interestingly, to about one in four patients with MCI (27%). Gingko and nootropics are prescribed infrequently, but in MCI two to three times more often than in AD. About one in four (27%) and one in ten (9%) MCI patient are prescribed SSRIs and benzodiazepines, a proportion similar to that of AD (28% and 10%), while atypical and traditional neuroleptics are virtually never used in MCI patients. Vitamin E is prescribed to more than half of MCI (57%) and in about half as many AD patients (27%).


CONCLUSIONS
These data suggest that lacking approved or clearly effective drugs for cognitive symptoms, physicians respond with 'analogy treatments' and by increasing the prescription of 'accessory drugs'. Non cognitive symptoms in MCI are managed virtually exclusively with SSRIs and benzodiazepines.
Frisoni
Giovanni B
GB
Laboratory of Epidemiology Neuroimaging & Telemedicine, IRCCS San Giovanni di Dio-FBF, Brescia, Italy. papers@centroAlzheimer.it
Canu
Elisa
E
Geroldi
Cristina
C
Zanetti
Orazio
O
Zacchi
Valeria
V
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy*; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014810:Vitamin E / Q000627:therapeutic use*; D014815:Vitamins / Q000627:therapeutic use
D002800:Cholinesterase Inhibitors; D018697:Nootropic Agents; D014815:Vitamins; D014810:Vitamin E