title: Clinical efficacy of aniracetam, either as monotherapy or combined with cholinesterase inhibitors, in patients with cognitive impairment: a comparative open study.
abstract: BACKGROUND
  Dementia constitutes an increasingly prevalent cognitive disorder with serious socioeconomic implications.
  
  
  OBJECTIVE
  In the present study, we aimed to evaluate the efficacy of aniracetam, either as monotherapy or combined with cholinesterase inhibitors (ChEIs), in terms of several neuropsychological parameters, in a considerable number of patients with dementia.
  
  
  RESULTS
  In our prospective, open-label study, we enrolled a total of 276 patients (mean age 71 ± 8 years, 95 males) with cognitive disorders. Our study population comprised four groups: no treatment group (n = 75), aniracetam monotherapy group (n = 58), ChEIs monotherapy group (n = 68), and group of combined treatment (n = 68). Patients were examined with validated neuropsychological tests at baseline, 3, 6, and 12 months of treatment. In patients treated with aniracetam, all studied parameters were adequately maintained at 6 and 12 months, while emotional state was significantly improved at 3 months. In patients treated with ChEIs, we observed a significant cognitive deterioration at 12 months. The comparison between aniracetam and ChEIs in patients with relatively mild dementia (15 ≤ MMSE ≤ 25) revealed a significantly better cognitive performance with aniracetam at 6 months and improved functionality at 3 months. Comparing aniracetam monotherapy with combined treatment in the same population, aniracetam performed better in the cognitive scale at 6 months, and displayed a notable tendency for enhanced mood at 12 months and improved functionality at 6 months.
  
  
  CONCLUSIONS
  Our findings indicate that aniracetam (a nootropic compound with glutamatergic activity and neuroprotective potential) is a promising option for patients with cognitive deficit of mild severity. It preserved all neuropsychological parameters for at least 12 months, and seemed to exert a favorable effect on emotional stability of demented patients.
authors: Third Department of Neurology, Aristotle University of Thessaloniki, General Hospital G. Papanikolaou, Exohi, Thessaloniki, Greece. ckoliaki@yahoo.com
authors: Chrysi C
authors: CC
authors: Koliaki
authors: Chaido
authors: C
authors: Messini
authors: Magda
authors: M
authors: Tsolaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D003072:Cognition Disorders / Q000188:drug therapy* / Q000523:psychology*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D011760:Pyrrolidinones / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D018697:Nootropic Agents; D011760:Pyrrolidinones; C036466:aniracetam