Cholinesterase inhibitors and memantine: evidence or intuition driven choices? Review article
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Published:
Dec 31, 2013
Keywords:
cholinesterase inhibitors, memantine, Alzheimer’s disease, dementia, treatment, clinical practice
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Abstract
Symptomatic drugs to treat dementia in the course of Alzheimer’s disease (cholinesterase inhibitors) have been present on the markets for many years now. Physicians consider these drugs as well known and often perceive themselves as experienced in their use, while pharmaceutical industry treat them as „mature” products that need no special attention. In clinical trial moderate efficacy of these drugs have been confirmed considering cognition, behavioral disturbances and activities of daily living. The impact on the natural course of the disease-specific neurodegenerative process remains, however, controversial. In the current paper clinical use of cholinesterase inhibitors and memantine as well as recommendations for their choice in practice are critically discussed. Moreover, recommendations considering drug switching (within cholinesterase inhibitors class) and obligatory precautions (contraindications, drug interactions) are taken into account.
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References
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19. Massoud F, Desmarais JE, Gauthier S. Switching cholinesterase inhibitors in older adults with dementia. Int Psychogeriatr 2011; 23: 372-8.
20. Sadowsky C, Perez JA, Bouchard RW et al. Switching from oral cholinesterase inhibitors to the rivastigmine transdermal patch. CNS Neurosci Ther 2010; 16: 51-60.
21. Sobów T. Farmakoterapia zaburzeń funkcji poznawczych w chorobie Alzheimera. W: Diagnostyka i leczenie otępień. Rekomendacje zespołu ekspertów Polskiego Towarzystwa Alzheimerowskiego. Medisfera, Warszawa 2012
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26. Gauthier S, Molinuevo JL. Benefits of combined cholinesterase inhibitor and memantine treatment in moderate-severe Alzheimer’s disease. Alzheimers Dement 2013; 9: 326-31.
27. Danysz W, Parsons CG, Mobius HJ et al. Neuroprotective and symptomatological action of memantine relevant for Alzheimer’s disease – a unified glutamatergic hypothesis of mechanism of action. Neurotoxicity Res 2000; 2: 85-97.
28. Flirski M, Sobów M. Memantyna – strategia glutaminergiczna w leczeniu choroby Alzheimera. Farmakoter Psychiatr Neurol 2006; 3-4: 177-86.
29. Herrmann N, Li A, Lanctot K. Memantine in dementia: review of the current evidence. Expert Opin Pharmacother 2011; 12: 787-800.
30. Schneider LS, Dagerman KS, Higgins JP et al. Lack of evidence for the efficacy of memantine in mild Alzheimer disease. Arch Neurol 2011; 68: 991-8.
31. Muayqil T, Camicioli R. Systematic review and meta-analysis of combination therapy with cholinesterase inhibitors and memantine in Alzheimer’s disease and other dementias. Dement Geriatr Cogn Disord Extra 2012; 2: 546-72.
32. Farrimond LE, Roberts E, McShane R. Memantine and cholinesterase inhibitor combination therapy for Alzheimer’s disease: a systematic review. BMJ Open 2012; 2: e000917.
33. Atri A, Shaughnessy LW, Locascio JJ et al. Long-term course and effectiveness of combination therapy in Alzheimer disease. Alzheimer Dis Assoc Disord. 2008; 22: 209-21.
34. Lopez OL, Becker JT, Wahed AS et al. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatry 2009; 80(6): 600-7.
35. Roundtree SD, Atri A, Lopez O et al. Effectiveness of antidementia drugs in delaying Alzheimer’s disease progression. Alzheimers Dement 2013; 9: 338-45.
36. Riordan KC, Hoffman Snyder CR, Wellik KE et al. Effectiveness of adding memantine to an Alzheimer dementia treatment regimen which already includes stable donepezil therapy: a critically appraised topic. Neurologist 2011; 17: 121-3.
37. Rolinski M, Fox C, Maidment I et al. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev 2012; 3: CD006504.
38. McKeith I, Del Ser T, Spano P et al. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo- controlled international study. Lancet 2000; 356(9247): 2031-6.
39. Hindle JV. The practical management of cognitive impairment and psychosis in the older Parkinson’s disease patient. J Neural Transm 2013; 120: 649-53.
40. Aarsland D, Ballard C, Walker Z et al. Memantine in patients with Parkinson’s disease dementia or dementia with Lewy bodies: a double-blind, placebo-controlled, multicentre trial. Lancet Neurol 2009; 8(7):613-8.
41. Emre M, Tsolaki M, Bonuccelli U et al., 11018 Study Investigators. Memantine for patients with Parkinson’s disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial. Lancet Neurol 2010; 9(10): 969-77.
42. Kavirajan H, Schneider LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol 2007; 6(9): 782-92.
43. Bullock R, Erkinjuntti T, Lilienfeld S; GAL-INT-6 Study Group. Management of patients with Alzheimer’s disease plus cerebrovascular disease: 12-month treatment with galantamine. Dement Geriatr Cogn Disord 2004; 17(1-2): 29-34.
44. Potkin SG, Alva G, Gunay I et al. A pilot study evaluating the efficacy and safety of rivastigmine in patients with mixed dementia. Drugs Aging 2006; 23(3): 241-9.
45. Rockwood K, Mitnitski A, Black SE et al., VASPECT study investigators. Cognitive change in donepezil treated patients with vascular or mixed dementia. Can J Neurol Sci 2013; 40(4): 564-71.
46. Sobów T, Kłoszewska I. Cholinesterase inhibitors in mild cognitive impairment: a meta-analysis of randomized controlled trials. Neurol Neurochir Pol 2007; 41(1): 13-21.
47. Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database Syst Rev 2012; 9: CD009132.
48. Jiang T, Yu JT, Tan L. Novel disease-modifying therapies for Alzheimer’s disease. J Alzheimers Dis 2012; 31(3): 475-92.
49. Honig LS, Boyd CD. Treatment of Alzheimer’s Disease: Current Management and Experimental Therapeutics. Curr Transl Geriatr Exp Gerontol Rep 2013; 2(3): 174-181.
50. Misra S, Medhi B. Drug development status for Alzheimer’s disease: present scenario. Neurol Sci 2013; 34: 831-9.
2. Dorenlot P. Démence et interventions non médicamenteuses: revue critique, bilan et perspectives. Psychol Neuropsychiatr Vieil 2006; 4: 135-44.
3. Schneider LS. Alzheimer disease pharmacologic treatment and treatment research. Continuum (Minneap Minn) 2013; 19: 339-57.
4. Raina P, Santaguida P, Ismaila A et al. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: evidence review for a clinical practice guideline. Ann Intern Med 2008; 148: 379-97.
5. Ballard C, Corbett A. Management of neuropsychiatric symptoms in people with dementia. CNS Drugs 2010; 24: 729-39.
6. Craig LA, Hong NS, McDonald RJ. Revisiting the cholinergic hypothesis in the development of Alzheimer’s disease. Neurosci Biobehav Rev 2011; 35: 1397-409.
7. Francis PT. The Interplay of neurotransmitters in Alzheimer’s disease. CNS Spectr 2005; 10: 6-9.
8. Whitehouse PJ, Price DL, Struble RG et al. Alzheimer’s disease and senile dementia: loss of neurons in the basal forebrain. Science 1982; 215: 1237-9.
9. Farlow MR, Cummings JL. Effective pharmacologic management of Alzheimer’s disease. Am J Med 2007; 120: 388-97.
10. Li J, Wu HM, Zhou RL et al. Huperzine A for Alzheimer’s disease. Cochrane Database Syst Rev 2008; 2: CD005592.
11. Bond M, Rogers G, Peters J et al. The effectiveness and cost-effectiveness of donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease (review of Technology Appraisal No. 111): a systematic review and economic model. Health Technol Asess 2012; 16: 1-470.
12. Hansen RA, Gartlehner G, Webb AP et al. Efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer’s disease: a systematic review and meta-analysis. Clin Interv Aging 2008; 3: 211-25.
13. Kaduszkiewicz H, Zimmermann T, Beck-Bornholdt HP et al. Cholinesterase inhibitors for patients with Alzheimer’s disease: systematic review of randomised clinical trials. BMJ 2005; 331: 321-7.
14. Hansen HA, Gartlehner G, Lohr KN et al. Functional outcomes of drug treatment in Alzheimer’s disease. Drugs Aging 2007; 24: 155-67.
15. Campbell N, Ayub A, Boustani MA et al. Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer’s disease: a meta-analysis. Clin Interv Aging 2008; 3: 719-28.
16. Rodda J, Morgan S, Walker Z. 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. Int Psychogeriatr 2009; 21: 813024.
17. Takeda A, Loveman E, Clegg A et al. A systematic review of the clinical effectiveness of donepezil, rivastigmine and galantamine on cognition, quality of life and adverse events in Alzheimer’s disease. Int J Geriatr Psychiatry 2006; 21: 17-28.
18. Lockhart IA, Mitchell SA, Kelly S. Safety and tolerability of donepezil, rivastigmine and galantamine for patients with Alzheimer’s disease: systematic review of the ‘real-world’ evidence. Dement Geriatr Cogn Disord 2009; 28: 389-403.
19. Massoud F, Desmarais JE, Gauthier S. Switching cholinesterase inhibitors in older adults with dementia. Int Psychogeriatr 2011; 23: 372-8.
20. Sadowsky C, Perez JA, Bouchard RW et al. Switching from oral cholinesterase inhibitors to the rivastigmine transdermal patch. CNS Neurosci Ther 2010; 16: 51-60.
21. Sobów T. Farmakoterapia zaburzeń funkcji poznawczych w chorobie Alzheimera. W: Diagnostyka i leczenie otępień. Rekomendacje zespołu ekspertów Polskiego Towarzystwa Alzheimerowskiego. Medisfera, Warszawa 2012
22. Cummings J, Jones R, Wilkinson D et al. Effect of donepezil on cognition in severe Alzheimer’s disease: a pooled data analysis. J Alzheimers Dis 2010; 21: 843-51.
23. Farlow MR, Salloway S, Tariot P et al. Effectiveness and tolerability of high-dose (23 mg/d) versus standard-dose (10 mg/d) donepezil in moderate to severe Alzheimer’s disease: A 24-week, randomized, double-blind study. Clin Ther 2010; 32: 1234-51.
24. Farlow MR, Grossberg GT, Sadowsky CH et al. A 24-week, randomized, controlled trial of rivastigmine patch 13.3 mg/24 h versus 4.6 mg/24 h in severe Alzheimer’s dementia. CNS Neurosci Ther 2013; 19: 745-52.
25. Sobow T. Combination treatments in Alzheimer’s disease: risks and benefits. Expert Rev Neurother 2010; 10: 693-702.
26. Gauthier S, Molinuevo JL. Benefits of combined cholinesterase inhibitor and memantine treatment in moderate-severe Alzheimer’s disease. Alzheimers Dement 2013; 9: 326-31.
27. Danysz W, Parsons CG, Mobius HJ et al. Neuroprotective and symptomatological action of memantine relevant for Alzheimer’s disease – a unified glutamatergic hypothesis of mechanism of action. Neurotoxicity Res 2000; 2: 85-97.
28. Flirski M, Sobów M. Memantyna – strategia glutaminergiczna w leczeniu choroby Alzheimera. Farmakoter Psychiatr Neurol 2006; 3-4: 177-86.
29. Herrmann N, Li A, Lanctot K. Memantine in dementia: review of the current evidence. Expert Opin Pharmacother 2011; 12: 787-800.
30. Schneider LS, Dagerman KS, Higgins JP et al. Lack of evidence for the efficacy of memantine in mild Alzheimer disease. Arch Neurol 2011; 68: 991-8.
31. Muayqil T, Camicioli R. Systematic review and meta-analysis of combination therapy with cholinesterase inhibitors and memantine in Alzheimer’s disease and other dementias. Dement Geriatr Cogn Disord Extra 2012; 2: 546-72.
32. Farrimond LE, Roberts E, McShane R. Memantine and cholinesterase inhibitor combination therapy for Alzheimer’s disease: a systematic review. BMJ Open 2012; 2: e000917.
33. Atri A, Shaughnessy LW, Locascio JJ et al. Long-term course and effectiveness of combination therapy in Alzheimer disease. Alzheimer Dis Assoc Disord. 2008; 22: 209-21.
34. Lopez OL, Becker JT, Wahed AS et al. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatry 2009; 80(6): 600-7.
35. Roundtree SD, Atri A, Lopez O et al. Effectiveness of antidementia drugs in delaying Alzheimer’s disease progression. Alzheimers Dement 2013; 9: 338-45.
36. Riordan KC, Hoffman Snyder CR, Wellik KE et al. Effectiveness of adding memantine to an Alzheimer dementia treatment regimen which already includes stable donepezil therapy: a critically appraised topic. Neurologist 2011; 17: 121-3.
37. Rolinski M, Fox C, Maidment I et al. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev 2012; 3: CD006504.
38. McKeith I, Del Ser T, Spano P et al. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo- controlled international study. Lancet 2000; 356(9247): 2031-6.
39. Hindle JV. The practical management of cognitive impairment and psychosis in the older Parkinson’s disease patient. J Neural Transm 2013; 120: 649-53.
40. Aarsland D, Ballard C, Walker Z et al. Memantine in patients with Parkinson’s disease dementia or dementia with Lewy bodies: a double-blind, placebo-controlled, multicentre trial. Lancet Neurol 2009; 8(7):613-8.
41. Emre M, Tsolaki M, Bonuccelli U et al., 11018 Study Investigators. Memantine for patients with Parkinson’s disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial. Lancet Neurol 2010; 9(10): 969-77.
42. Kavirajan H, Schneider LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol 2007; 6(9): 782-92.
43. Bullock R, Erkinjuntti T, Lilienfeld S; GAL-INT-6 Study Group. Management of patients with Alzheimer’s disease plus cerebrovascular disease: 12-month treatment with galantamine. Dement Geriatr Cogn Disord 2004; 17(1-2): 29-34.
44. Potkin SG, Alva G, Gunay I et al. A pilot study evaluating the efficacy and safety of rivastigmine in patients with mixed dementia. Drugs Aging 2006; 23(3): 241-9.
45. Rockwood K, Mitnitski A, Black SE et al., VASPECT study investigators. Cognitive change in donepezil treated patients with vascular or mixed dementia. Can J Neurol Sci 2013; 40(4): 564-71.
46. Sobów T, Kłoszewska I. Cholinesterase inhibitors in mild cognitive impairment: a meta-analysis of randomized controlled trials. Neurol Neurochir Pol 2007; 41(1): 13-21.
47. Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database Syst Rev 2012; 9: CD009132.
48. Jiang T, Yu JT, Tan L. Novel disease-modifying therapies for Alzheimer’s disease. J Alzheimers Dis 2012; 31(3): 475-92.
49. Honig LS, Boyd CD. Treatment of Alzheimer’s Disease: Current Management and Experimental Therapeutics. Curr Transl Geriatr Exp Gerontol Rep 2013; 2(3): 174-181.
50. Misra S, Medhi B. Drug development status for Alzheimer’s disease: present scenario. Neurol Sci 2013; 34: 831-9.