Therapeutic effects of drug switching between acetylcholinesterase inhibitors in patients with Alzheimer's disease

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim: To evaluate the therapeutic effects of switching from one acetylcholinesterase inhibitor (ChEI), donepezil, galantamine or rivastigmine, to another in Alzheimer's disease patients. Methods: We retrospectively enrolled 171 Alzheimer's disease patients, whose ChEI medication was changed. The patients were evaluated on three major aspects of dementia - cognitive, affective and activities of daily living (ADL) measures - at 6 months (M) before the drug switch, at the time of drug switch (baseline), and at 3 M and 6 M after the drug switch. Results: The doses of the three ChEI were significantly lower at 6 M after the switch compared with the pre-switch doses. Improvements in apathy were found at 3 M when switching from donepezil to galantamine, but not to rivastigmine, but this switch had adverse effects on ADL. Improvements in cognitive scores at 3 M were also found when switching from galantamine to rivastigmine, but not to donepezil. However, both of these changes improved Abe's Behavioral and Psychological Symptoms of Dementia scores (ABS), except ADL. Switching from rivastigmine to donepezil worsened ABS at 6 M, but preserved cognitive and ADL scores. Conclusions: The present study suggests that despite a relatively lower dose of ChEI after the switch, switching from donepezil or rivastigmine preserved cognitive functions for at least 6 M. Switching from galantamine to rivastigmine improved Mini-Mental State Examination and ABS at 3 M, but did not improve ADL scores.

Original languageEnglish
JournalGeriatrics and Gerontology International
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Rivastigmine
Drug Substitution
Cholinesterase Inhibitors
Therapeutic Uses
dementia
Galantamine
Activities of Daily Living
Alzheimer Disease
drug
Dementia
apathy
Pharmaceutical Preparations
Apathy
Behavioral Symptoms
medication
Cognition
examination
donepezil

Keywords

  • Alzheimer's disease
  • Donepezil
  • Drug switch
  • Galantamine
  • Rivastigmine

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology

Cite this

@article{38ee2e1f966f4a9487d1f9ac0d6f484c,
title = "Therapeutic effects of drug switching between acetylcholinesterase inhibitors in patients with Alzheimer's disease",
abstract = "Aim: To evaluate the therapeutic effects of switching from one acetylcholinesterase inhibitor (ChEI), donepezil, galantamine or rivastigmine, to another in Alzheimer's disease patients. Methods: We retrospectively enrolled 171 Alzheimer's disease patients, whose ChEI medication was changed. The patients were evaluated on three major aspects of dementia - cognitive, affective and activities of daily living (ADL) measures - at 6 months (M) before the drug switch, at the time of drug switch (baseline), and at 3 M and 6 M after the drug switch. Results: The doses of the three ChEI were significantly lower at 6 M after the switch compared with the pre-switch doses. Improvements in apathy were found at 3 M when switching from donepezil to galantamine, but not to rivastigmine, but this switch had adverse effects on ADL. Improvements in cognitive scores at 3 M were also found when switching from galantamine to rivastigmine, but not to donepezil. However, both of these changes improved Abe's Behavioral and Psychological Symptoms of Dementia scores (ABS), except ADL. Switching from rivastigmine to donepezil worsened ABS at 6 M, but preserved cognitive and ADL scores. Conclusions: The present study suggests that despite a relatively lower dose of ChEI after the switch, switching from donepezil or rivastigmine preserved cognitive functions for at least 6 M. Switching from galantamine to rivastigmine improved Mini-Mental State Examination and ABS at 3 M, but did not improve ADL scores.",
keywords = "Alzheimer's disease, Donepezil, Drug switch, Galantamine, Rivastigmine",
author = "Yasuyuki Ohta and Mohamed Darwish and Nozomi Hishikawa and Toru Yamashita and Kota Sato and Mami Takemoto and Koji Abe",
year = "2017",
doi = "10.1111/ggi.12971",
language = "English",
journal = "Geriatrics and Gerontology International",
issn = "1447-0594",
publisher = "Japan Geriatrics Society",

}

TY - JOUR

T1 - Therapeutic effects of drug switching between acetylcholinesterase inhibitors in patients with Alzheimer's disease

AU - Ohta, Yasuyuki

AU - Darwish, Mohamed

AU - Hishikawa, Nozomi

AU - Yamashita, Toru

AU - Sato, Kota

AU - Takemoto, Mami

AU - Abe, Koji

PY - 2017

Y1 - 2017

N2 - Aim: To evaluate the therapeutic effects of switching from one acetylcholinesterase inhibitor (ChEI), donepezil, galantamine or rivastigmine, to another in Alzheimer's disease patients. Methods: We retrospectively enrolled 171 Alzheimer's disease patients, whose ChEI medication was changed. The patients were evaluated on three major aspects of dementia - cognitive, affective and activities of daily living (ADL) measures - at 6 months (M) before the drug switch, at the time of drug switch (baseline), and at 3 M and 6 M after the drug switch. Results: The doses of the three ChEI were significantly lower at 6 M after the switch compared with the pre-switch doses. Improvements in apathy were found at 3 M when switching from donepezil to galantamine, but not to rivastigmine, but this switch had adverse effects on ADL. Improvements in cognitive scores at 3 M were also found when switching from galantamine to rivastigmine, but not to donepezil. However, both of these changes improved Abe's Behavioral and Psychological Symptoms of Dementia scores (ABS), except ADL. Switching from rivastigmine to donepezil worsened ABS at 6 M, but preserved cognitive and ADL scores. Conclusions: The present study suggests that despite a relatively lower dose of ChEI after the switch, switching from donepezil or rivastigmine preserved cognitive functions for at least 6 M. Switching from galantamine to rivastigmine improved Mini-Mental State Examination and ABS at 3 M, but did not improve ADL scores.

AB - Aim: To evaluate the therapeutic effects of switching from one acetylcholinesterase inhibitor (ChEI), donepezil, galantamine or rivastigmine, to another in Alzheimer's disease patients. Methods: We retrospectively enrolled 171 Alzheimer's disease patients, whose ChEI medication was changed. The patients were evaluated on three major aspects of dementia - cognitive, affective and activities of daily living (ADL) measures - at 6 months (M) before the drug switch, at the time of drug switch (baseline), and at 3 M and 6 M after the drug switch. Results: The doses of the three ChEI were significantly lower at 6 M after the switch compared with the pre-switch doses. Improvements in apathy were found at 3 M when switching from donepezil to galantamine, but not to rivastigmine, but this switch had adverse effects on ADL. Improvements in cognitive scores at 3 M were also found when switching from galantamine to rivastigmine, but not to donepezil. However, both of these changes improved Abe's Behavioral and Psychological Symptoms of Dementia scores (ABS), except ADL. Switching from rivastigmine to donepezil worsened ABS at 6 M, but preserved cognitive and ADL scores. Conclusions: The present study suggests that despite a relatively lower dose of ChEI after the switch, switching from donepezil or rivastigmine preserved cognitive functions for at least 6 M. Switching from galantamine to rivastigmine improved Mini-Mental State Examination and ABS at 3 M, but did not improve ADL scores.

KW - Alzheimer's disease

KW - Donepezil

KW - Drug switch

KW - Galantamine

KW - Rivastigmine

UR - http://www.scopus.com/inward/record.url?scp=85008502032&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008502032&partnerID=8YFLogxK

U2 - 10.1111/ggi.12971

DO - 10.1111/ggi.12971

M3 - Article

C2 - 28060449

AN - SCOPUS:85008502032

JO - Geriatrics and Gerontology International

JF - Geriatrics and Gerontology International

SN - 1447-0594

ER -