title: Effect of Rivastigmine on Behavioral and Psychiatric Symptoms of Parkinson's Disease Dementia.
abstract: OBJECTIVE
  A recent study showed that rivastigmine and memantin improved behavioral and psychiatric symptoms of dementia (BPSD) in Alzheimer's dementia. Furthermore, according to recent guidelines presented by the Movement Disorder Society, rivastigmine is efficacious for the treatment of dementia in Parkinson's disease (PD). We investigated the efficacy of rivastigmine for BPSD in patients with Parkinson's disease dementia (PDD).
  
  
  METHODS
  Twenty-three patients in whom cognitive impairment occurred at least one year after a diagnosis of PD participated in this open-label trial. Cognitive, psychiatric, and motor symptoms were assessed before and after 24 weeks of treatment with rivastigmine using unstructured clinical assessments and rating scales including the Unified Parkinson's Disease Rating Scale, Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory.
  
  
  RESULTS
  Age (± standard deviation) was 74.7 ± 5.9 years, average duration of PD was 3.5 ± 3.7 years, Hoehn and Yahr scores were 2.2 ± 0.8, and baseline MMSE scores were 19.1 ± 4.2. Improvements in global mental symptoms and neuropsychiatric symptoms were significant; among them, hallucination, depression and appetite changes improved. Caregiver distress significantly decreased, including distress resulting from hallucinations, depression, apathy, and appetite changes.
  
  
  CONCLUSIONS
  Although controlled trials are required, the findings suggest that rivastigmine is useful for control of several neuropsychiatric symptoms and beneficial for caregiver distress in patients with PDD.
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yoon-Sang
authors.initials: YS
authors.lastname: Oh
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Joong-Seok
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Phil Hyu
authors.initials: PH
authors.lastname: Lee
keywords: Dementia; Neuropsychiatry; Parkinson disease; Rivastigmine; Symptoms