Different responses to rivastigmine in subcortical vascular dementia and multi-infarct dementia.
Vascular dementia (VaD) is associated with a large amount of heterogeneity, as it groups together a broad category of patients in whom various manifestations of cognitive decline are attributed to cerebrovascular or cardiovascular disease. Thus, a study was designed to determine the effects of rivastigmine on cognitive function, global daily living performance, and behavioral disorders in VaD patients versus an active control (nimodipine), stratifying patients according to the type of VaD, subcortical vascular dementia (sVAD), and multi-infarct dementia (MID). The trial was a prospective study. This study shows that long-term treatment with rivastigmine, at dosages approved for therapeutic use in Alzheimer's disease, produces significant improvement in all behavioral symptoms in 2 forms of VaD, MID and sVaD, except delusions. It also suggests that rivastigmine may enable a reduction in concomitant neuroleptics and benzodiazepines in VaD, especially in MID. The results are discussed with an overview of the literature.
Moretti
Rita
R
Department of Medicine and Neurology, University of Trieste, Trieste, Italy. moretti@univ.trieste.it
Torre
Paola
P
Antonello
Rodolfo M
RM
Cazzato
Giuseppe
G
Pizzolato
Gilberto
G
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000188:drug therapy / Q000523:psychology; D003702:Delusions / Q000188:drug therapy / Q000523:psychology; D015161:Dementia, Multi-Infarct / Q000188:drug therapy* / Q000523:psychology; D015140:Dementia, Vascular / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects; D009325:Nausea / Q000139:chemically induced; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use; D009483:Neuropsychological Tests; D009553:Nimodipine / Q000009:adverse effects / Q000627:therapeutic use; D048448:Phenylcarbamates / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D000068836:Rivastigmine; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use
D014150:Antipsychotic Agents; D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D014665:Vasodilator Agents; D001569:Benzodiazepines; D009553:Nimodipine; D000068836:Rivastigmine