✍ Scribed by A. Åhlin; H. Nybäck; T. Junthe; G. Öhman; I. Nordgren
No coin nor oath required. For personal study only.
The cognitive decline in Alzheimer's disease has been shown to correlate with deficits in central cholinergic neurotransmission. Among various treatment attempts using cholinergic drugs a trial of the cholinesterase inhibitor tetrahydroaminoacridine (THA) (Summers et al., 1986) attracted considerable interest due to the positive effects reported on dementia symptoms. We have studied the effects of THA and placebo in a double-blind crossover trial over 9 weeks in 15 patients with dementia of Alzheimer type. Doses of the drug (75-150mdday) were titrated for each patient before entering the study. Clinical and biochemical effects were monitored using a battery of psychological tests, clinical rating scales and laboratory tests, including measurements of monoamine metabolites in the cerebrospinal fluid (CSF). The clinical results were mostly negative. Almost half of the patients had elevated liver enzymes (ALT and AST) in the THA period and these subjects showed more improvements of clinical ratings and psychological tests than did the patients without elevated liver enzymes. Levels of acetylcholine and the monoamine metabolites HVA and 5-HIAA in CSF were elevated on THA. The results indicate that THA has a therapeutic potential, although its pharmacokinetic profile and its liability to induce liver damage may limit the clinical use of the drug in the future.
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## Objective: To evaluate the efficacy and safety of low-dose risperidone in treating psychosis of alzheimer's disease (ad) and mixed dementia (md) in a subset of nursing-home residents who had dementia and aggression and who were participating in a randomized placebo-controlled trial of risperidon