Acetylcholinesterase Inhibitors (AChEI's) for the treatment of visual hallucinations in schizophrenia: a review of the literature.
BACKGROUND
Visual hallucinations occur in various neurological diseases, but are most prominent in Lewy body dementia, Parkinson's disease and schizophrenia. The lifetime prevalence of visual hallucinations in patients with schizophrenia is much more common than conventionally thought and ranges from 24% to 72%. Cortical acetylcholine (ACh) depletion has been associated with visual hallucinations; the level of depletion being related directly to the severity of the symptoms. Current understanding of neurobiological visual processing and research in diseases with reduced cholinergic function, suggests that AChEI's may prove beneficial in treating visual hallucinations. This offers the potential for targeted drug therapy of clinically symptomatic visual hallucinations in patients with schizophrenia using acetylcholinesterase inhibition.


METHODS
A systematic review was carried out investigating the evidence for the effects of AChEI's in treating visual hallucinations in Schizophrenia.


RESULTS
No evidence was found relating to the specific role of AChEI's in treating visual hallucinations in this patient group.


CONCLUSIONS
Given the use of AChEI's in targeted, symptom specific treatment in other neuropsychiatric disorders, it is surprising to find no related literature in schizophrenia patients. The use of AChEI's in schizophrenia has investigated effects on cognition primarily with non cognitive effects measured more broadly.


CONCLUSIONS
We would suggest that more focused research into the effects of AChEI's on positive symptoms of schizophrenia, specifically visual hallucinations, is needed.
Patel
Sachin S
SS
National Psychosis Unit, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Rd, Beckenham BR33BX, UK.
Attard
Azizah
A
Jacobsen
Pamela
P
Shergill
Sukhi
S
D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D000077265:Donepezil; D005702:Galantamine / Q000627:therapeutic use; D006212:Hallucinations / Q000188:drug therapy*; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D048448:Phenylcarbamates / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D000068836:Rivastigmine; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D007189:Indans; D048448:Phenylcarbamates; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine
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