title: Pharmacological Management of Lewy Body Dementia: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  The authors examined research on effects, costs, and patient and caregiver views of pharmacological management strategies for Lewy body dementia.
  
  
  METHODS
  Studies were identified through bibliographic databases, trials registers, gray literature, reference lists, and experts. The authors used the search terms "Lewy or parkinson" and "dementia" through March 2015 and used the following inclusion criteria: participants with diagnoses of Lewy body dementia, dementia with Lewy bodies, or Parkinson's disease dementia (or participants' caregivers); investigation of pharmacological management strategies; outcome measures and test scores reported. Data extraction and quality assessment were conducted by at least two authors. Meta-analyses were conducted, and when studies could not be combined, summaries were provided.
  
  
  RESULTS
  Forty-four studies examining 22 strategies were included in the review. Meta-analysis indicated beneficial effects of donepezil and rivastigmine for cognitive and psychiatric symptoms. Rivastigmine, but not donepezil, was associated with greater risk of adverse events. Meta-analysis of memantine suggested that it is well tolerated but with few benefits. Descriptive summaries provide some evidence of benefits for galantamine, modafinil, levodopa, rotigotine, clozapine, duloxetine, clonazepam, ramelteon, gabapentin, zonisamide, and yokukansan. Piracetam, amantadine, selegiline, olanzapine, quetiapine, risperidone, and citalopram do not appear to be effective.
  
  
  CONCLUSIONS
  High-level evidence related to pharmacological strategies for managing Lewy body dementia is rare. Strategies for important areas of need in Lewy body dementia, such as autonomic symptoms and caregiver burden, have not been investigated, nor have the views of patients and caregivers about pharmacological strategies.
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Stinton
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: McKeith
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Taylor
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Lafortune
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: Eneida
authors.initials: E
authors.lastname: Mioshi
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: Elijah
authors.initials: E
authors.lastname: Mak
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: Victoria
authors.initials: V
authors.lastname: Cambridge
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Mason
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Thomas
authors.affiliation: From the Department of Psychiatry, the Department of Clinical Neurosciences, and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; the Institute of Neuroscience, University of Newcastle, Newcastle, United Kingdom; and the School of Medicine, Pharmacy, and Health, Durham University, Durham, United Kingdom.
authors.forename: John T
authors.initials: JT
authors.lastname: O'Brien
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D017028:Caregivers; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D006801:Humans; D020961:Lewy Body Disease / Q000188:drug therapy* / Q000523:psychology; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D018697:Nootropic Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018691:Excitatory Amino Acid Antagonists; D018696:Neuroprotective Agents; D018697:Nootropic Agents