Hidenobu Suzuki1, Yuichi Inoue2, Katsunaka Mikami3, Keishi Gen4. 1. Department of Psychiatry, Suzuki Clinic, 3-34-16 Hamadayama, Suginami, Tokyo, 168-0065, Japan. 2. Shakomae Kokorono Clinic, Tokyo, Japan. 3. Department of Psychiatry, Tokai University School of Medicine, Kanagawa, Japan. 4. Department of Psychiatry, Seimo Hospital, Gunma, Japan.
Abstract
OBJECTIVE: We investigated the influence on behavioral and psychological symptoms on dementia (BPSD) and the changes in the dosages of concomitant psychotropic drugs associated with the discontinuation of donepezil in patients with severe Alzheimer's disease (AD) who developed BPSD during donepezil therapy. METHODS: The subjects were 44 inpatients who had been diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). The outcome measures assessed were BPSD and cognitive function. BPSD was assessed using the Neuropsychiatric Inventory (NPI) and cognitive function was assessed using the Mini Mental Examination (MMSE). The changes in the dosages of concomitant psychotropic drugs were also assessed. RESULTS: Significant decreases were found in the donepezil treatment discontinuation group in the following NPI total score and two NPI subscales (agitation and irritability), but no significant differences were seen between the donepezil treatment discontinuation group and the control group. Furthermore, the mean changes from baseline in the risperidone equivalent dose and the diazepam equivalent dose were hardly changed in the donepezil treatment discontinuation group. CONCLUSION: The results of this study suggest that the discontinuation of donepezil treatment in patients with AD with BPSD may afford superior efficacy and may make it possible to not increase the dosage of other psychotropic drugs.
OBJECTIVE: We investigated the influence on behavioral and psychological symptoms on dementia (BPSD) and the changes in the dosages of concomitant psychotropic drugs associated with the discontinuation of donepezil in patients with severe Alzheimer's disease (AD) who developed BPSD during donepezil therapy. METHODS: The subjects were 44 inpatients who had been diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). The outcome measures assessed were BPSD and cognitive function. BPSD was assessed using the Neuropsychiatric Inventory (NPI) and cognitive function was assessed using the Mini Mental Examination (MMSE). The changes in the dosages of concomitant psychotropic drugs were also assessed. RESULTS: Significant decreases were found in the donepezil treatment discontinuation group in the following NPI total score and two NPI subscales (agitation and irritability), but no significant differences were seen between the donepezil treatment discontinuation group and the control group. Furthermore, the mean changes from baseline in the risperidone equivalent dose and the diazepam equivalent dose were hardly changed in the donepezil treatment discontinuation group. CONCLUSION: The results of this study suggest that the discontinuation of donepezil treatment in patients with AD with BPSD may afford superior efficacy and may make it possible to not increase the dosage of other psychotropic drugs.
Entities:
Keywords:
Alzheimer’s disease; behavioral and psychological symptoms on dementia; donepezil; psychotropic drugs
Authors: Joshua D Niznik; Xinhua Zhao; Meiqi He; Sherrie L Aspinall; Joseph T Hanlon; Laura C Hanson; David Nace; Joshua M Thorpe; Carolyn T Thorpe Journal: J Am Geriatr Soc Date: 2019-11-26 Impact factor: 5.562
Authors: Joshua D Niznik; Xinhua Zhao; Meiqi He; Sherrie L Aspinall; Joseph T Hanlon; David Nace; Joshua M Thorpe; Carolyn T Thorpe Journal: Alzheimers Dement Date: 2020-02-13 Impact factor: 21.566