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| |  ANA: Rivastigmine Provides Behavioral And Cognitive Benefits In Nursing Home Patients With Alzheimer’s By Ed Susman Special to DG News CHICAGO, IL -- October 3, 2001 -- Disruptive behavior associated with dementia in nursing home patients can be curbed by administration of rivastigmine, a cholinesterase inhibitor. Researchers reported the findings yesterday (Oct. 2) at the 126th annual meeting of the American Neurological Association, in Chicago, Illinois. In addition, after 26 weeks of treatment, Dr. Bijan Etemad, medical director of Geropsychiatric Clinical Services at the University of Pennsylvania Health System, Philadelphia, said, “Rivastigmine treatment resulted in a marked reduction in the use of psychotropic medications, with the majority of patients reducing their doses or terminating psychotropic treatment altogether.” Dr. Etemad and colleagues enrolled 213 patients in the open-label study, which was completed by 200 of the residents of a nursing home. The analysis of the trial included 64 men and 136 women. None of the patients who discontinued the medication did so for reasons related to the medication itself, Dr. Etemad said. The patients enrolled in the study were all diagnosed with Alzheimer’s disease, including multi-infarct dementia or dementia with Lewy bodies. The patients were eligible for the study if their behavior change required the administration of a psychotropic drug. Rivastigmine was initiated at 1.5 mg twice a day, and by the end of the first month of treatment all patients had been titrated to receive 6 mg twice a day of the drug. Dr. Etemad reported that patients’ baseline scores on the Mini-Mental State Examination increased from a score of 10 to a score of 15 after the 26-week trial. The Neuropsychiatric Inventory-Nursing Home version (NPI-NH) declined from an average of about 16 to about 11. When he examined the use of psychotropic agents, he found that 25 percent of patients on antipsychotics were able to reduce their dosages of medicine while on rivastigmine and the medication was withdrawn in 40 percent of the patients, compared with about 7 percent that required increases in medication. The story was similar for patients on anxiolytics, antidepressants and mood stabilizers, Dr. Etemad determined. “These results provide further evidence of the behavioral and cognitive benefits of rivastigmine treatment,” he said, “and also suggest that this cholinesterase inhibitor can permit the reduction or discontinuation of psychotropic agents, thereby avoiding the side effects and drug-illness interactions associated with psychotropic use.” The study was supported by Novartis Pharmaceuticals Corporation, East Hanover, New Jersey. Dr. Etemad is a consultant for Novartis.
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