Rivastigmine for the treatment of dementia associated with Parkinson's disease

Jennifer L. Reingold, John Christopher Morgan, Kapil Dev Sethi

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Parkinson's disease (PD) afflicts millions of people worldwide and leads to cognitive impairment or dementia in the majority of patients over time. Parkinson's disease dementia (PDD) is characterized by deficits in attention, executive and visuospatial function, and memory. The clinical diagnostic criteria and neuropathology surrounding PDD remain controversial with evidence of overlap among PDD, dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Cortical cholinergic deficits are greater in PDD than in AD, and are well-córrelated with the cognitive and neuropsychiatric dysfunction that occurs in PDD. Inhibition of acetylcholine metabolism is therefore a practical therapeutic strategy in PDD. This review examines current evidence for rivastigmine (a cholinesterase/ butyrylcholinesterase inhibitor) treatment in PDD. In addition to its efficacy, we examine the safety profile, side effects, and cost effectiveness of rivastigmine in PDD. Rivastigmine provides modest benefit in PDD and further long-term studies are needed to determine the effectiveness and safety of rivastigmine over time. Tolerability is a problem for many PDD patients treated with rivastigmine. Future studies of rivastigmine in PDD should focus on pragmatic outcomes such as time to need for nursing home placement, pharmacoeconomic outcomes and simultaneous patient/caregiver quality of life assessments.

Original languageEnglish (US)
Pages (from-to)775-783
Number of pages9
JournalNeuropsychiatric Disease and Treatment
Volume3
Issue number6
StatePublished - Dec 1 2007

Keywords

  • Cholinesterase inhibitor
  • Dementia
  • Parkinson's disease
  • Rivastigmine

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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