title: Efficacy of rivastigmine tartrate, transdermal system, in Alzheimer's disease.
abstract: BACKGROUND
  As the most common major neurocognitive disorder, Alzheimer's disease (AD) will play an increasingly important role both socially and financially as the population ages. Approved treatments for AD are symptomatic in nature and show modest improvements in cognition and global functioning among patients with AD.
  
  
  METHODS
  This article focuses on the pharmacokinetics, pharmacodynamics, efficacy, and safety of the transdermal patch form of the cholinesterase inhibitor rivastigmine. The rivastigmine transdermal system is approved for the treatment of patients with mild, moderate, and severe AD. Three randomized trials have shown the rivastigmine patch to be efficacious and tolerable across all stages of AD.
  
  
  CONCLUSIONS
  The rivastigmine patch offers several advantages over the capsule form, including decreased peak to trough plasma fluctuations, reduced rates of nausea and vomiting, better treatment adherence, higher probability of reaching the target dose, ease of administration, and greater satisfaction among caregivers. These factors may be especially important in patients with severe AD, in which patients are more vulnerable to adverse side effects from higher doses. While the patch is more expensive than generic therapies, patient populations that may benefit from the patch include those that are particularly sensitive to GI side effects, have chronic gastrointestinal problems, have difficulty swallowing medications, or have failed to respond with high doses of other generic options.
authors.affiliation: a Department of Psychiatry , St. Louis University School of Medicine , St Louis , MO , USA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Nieto
authors.affiliation: a Department of Psychiatry , St. Louis University School of Medicine , St Louis , MO , USA.
authors.forename: William James
authors.initials: WJ
authors.lastname: Deardorff
authors.affiliation: a Department of Psychiatry , St. Louis University School of Medicine , St Louis , MO , USA.
authors.forename: George T
authors.initials: GT
authors.lastname: Grossberg
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D006801:Humans; D009325:Nausea / Q000139:chemically induced; D000068836:Rivastigmine / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D057968:Transdermal Patch; D014839:Vomiting / Q000139:chemically induced
chemical_list: D002800:Cholinesterase Inhibitors; D000068836:Rivastigmine
keywords: Alzheimer’s disease; cholinesterase inhibitor; patch; rivastigmine; transdermal system