Moderate and severe dementia can benefit from donepezil
NEW research backs continuation of donepezil when patients with Alzheimer’s disease progress to moderate to severe dementia.
The multi-centre UK study of 295 patients treated with donepezil (Aricept) for at least three months showed that keeping them on the drug led to better cognitive functioning when compared with those discontinuing.
Further, patients in an arm of the trial assigned to receive memantine had higher mini mental state exam scores compared to patients assigned placebo after 12 months.
“For the first time we have robust and compelling evidence that treatment with these drugs can continue to help patients at the later, more severe stages of the disease,” lead author Professor Robert Howard said in a media statement.
While guidelines have advocated treatment with cholinesterase inhibitors, many advise discontinuation once Alzheimer’s progresses beyond a mild to moderate stage.
The study, funded by the UK Medical Research Council and Alzheimer’s Society (with drugs donated by pharmaceutical companies), suggested the decline in memory and functioning could be slowed, but not halted.
Patients in another arm of the trial were given a combination of donepezil and memantine but this demonstrated no significant benefit over donepezil alone.
N Engl J Med 2012;366:893-03