Are cholinesterase inhibitors effective in the management of the behavioral and psychological symptoms of dementia in Alzheimer's disease? A systematic review of randomized, placebo-controlled trials of donepezil, rivastigmine and galantamine

@article{Rodda2009AreCI,
  title={Are cholinesterase inhibitors effective in the management of the behavioral and psychological symptoms of dementia in Alzheimer's disease? A systematic review of randomized, placebo-controlled trials of donepezil, rivastigmine and galantamine},
  author={J. Rodda and S. Morgan and Z. Walker},
  journal={International Psychogeriatrics},
  year={2009},
  volume={21},
  pages={813 - 824}
}
ABSTRACT Background: The study aim was to conduct a systematic review of the evidence from randomized, placebo controlled trials related to the efficacy of donepezil, rivastigmine and galantamine in the treatment of behavioral and psychological symptoms of Alzheimer's disease. Methods: Electronic database searches of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were carried out using multiple search terms. Articles included were original publications of randomized… Expand
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References

SHOWING 1-10 OF 61 REFERENCES
Cholinesterase inhibitors for patients with Alzheimer's disease: systematic review of randomised clinical trials
TLDR
The scientific basis for recommendations of cholinesterase inhibitors for the treatment of Alzheimer's disease is questionable because of flawed methods and small clinical benefits. Expand
Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials.
  • L. Schneider, K. Dagerman, P. Insel
  • Medicine
  • The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
  • 2006
TLDR
Small statistical effect sizes on symptom rating scales support the evidence for the efficacy of aripiprazole and risperidone. Expand
Comparison of citalopram, perphenazine, and placebo for the acute treatment of psychosis and behavioral disturbances in hospitalized, demented patients.
TLDR
Citalopram was found to be more efficacious than placebo in the short-term hospital treatment of psychotic symptoms and behavioral disturbances in nondepressed, demented patients. Expand
The effectiveness of atypical antipsychotics for the treatment of aggression and psychosis in Alzheimer's disease.
TLDR
Evidence suggests that ris peridone and olanzapine are useful in reducing aggression and risperidone reduces psychosis, but both are associated with serious adverse cerebrovascular events and extra-pyramidal symptoms. Expand
Donepezil for the treatment of agitation in Alzheimer's disease.
TLDR
In this 12-week trial, donepezil was not more effective than placebo in treating agitation in patients with Alzheimer's disease. Expand
Efficacy of Donepezil on Behavioral Symptoms in Patients With Moderate to Severe Alzheimer's Disease
Objective: This subanalysis of a large, double-blind, placebo-controlled trial examined the prevalence of behavioral symptoms in moderate to severe Alzheimer's disease (AD), and the effect ofExpand
Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia.
TLDR
Only behavior management therapies, specific types of caregiver and residential care staff education, and possibly cognitive stimulation appear to have lasting effectiveness for the management of dementia-associated neuropsychiatric symptoms. Expand
Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial
TLDR
Neither quetiapine nor rivastigmine are effective in the treatment of agitation in people with dementia in institutional care and compared with placebo, quetoapine is associated with significantly greater cognitive decline. Expand
Effects of a flexible galantamine dose in Alzheimer's disease: a randomised, controlled trial
TLDR
Patients on galantamine, compared with those on placebo, experienced benefits in cognitive function and instrumental and basic activities of daily living and the effects of highest levels of dosing were compared. Expand
Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomised double-blind trial
TLDR
Donepezil is not cost effective, with benefits below minimally relevant thresholds, and more effective treatments than cholinesterase inhibitors are needed for Alzheimer's disease. Expand
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