Pharmacological Therapy for Apathy in Alzheimer's Disease: A Systematic Review and Meta-Analysis.
BACKGROUND
Apathy is highly prevalent in Alzheimer's disease (AD), but whether pharmacotherapy is effective in managing apathy is unclear.


METHODS
To assess the efficacy of pharmacotherapy for apathy in AD we searched for randomized controlled trials (RCT) and aggregate data reporting on apathy in several search engines, reference lists of articles, and reviews. Demographic characteristics and relevant data were extracted to assess apathy.


RESULTS
Fifteen RCTs' were examined, and 11 were used in aggregate meta-analytic statistics. Drugs included were cholinesterase inhibitors, memantine, and psycho-stimulants. We found no significant treatment effect in favour of any of the drugs, and the effect-size estimates under a random effect model were heterogeneous. Most RCTs had a high attrition rate and used the NPI apathy subscale to measure apathy.


CONCLUSIONS
The lack of an effect could be explained by methodological limitations, publication bias, and heterogeneity.
1University of British Columbia,Department of Medicine,Division of Neurology,Vancouver,Canada.
Amir A
http://orcid.org/0000-0002-6055-4457
AA
Sepehry
2College of Medicine,Kansas City University of Medicine & Biosciences,Kansas City,USA.
Michael
M
Sarai
1University of British Columbia,Department of Medicine,Division of Neurology,Vancouver,Canada.
Ging-Yuek R
GR
Hsiung
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology*; D057565:Apathy / Q000187:drug effects* / Q000502:physiology; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000379:methods; D018691:Excitatory Amino Acid Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008559:Memantine / Q000494:pharmacology / Q000627:therapeutic use*
D000697:Central Nervous System Stimulants; D002800:Cholinesterase Inhibitors; D018691:Excitatory Amino Acid Antagonists; D008559:Memantine
Alzheimer’s disease; Apathy; Clinical trials; Pharmacological treatment; Review