Affiliations: Study Group Gerontopsychiatry, Psychiatric Department,
University of Saarland, D-68421 Homburg/Saar, Germany. | Novartis Pharma GmbH, Roonstrasse 25, Nürnberg,
D-90429, Germany.
Note: [] Corresponding author: Dr. Wolfgang Retz, Study Group
Gerontopsychiatry, Department of Psychiatry, University of Saarland, D-66421
Homburg/Saar, Germany. Tel.: +49 6841 166351; Fax: +49 6841 166335; E-mail:
wolfgang.retz@med-rz.uni-sb.de.
Abstract: Alzheimer's disease (AD) is accompanied by prominent behavioural
disturbances. They cause significant distress for both caregivers and patients
and can play a major role in the decision to institutionalise AD patients.
Recent evidence suggests that cholinergic deficiencies not only contribute to
the memory and cognitive abnormalities of AD but are also responsible for some
behavioural abnormalities seen over the course of the disease. In this study we
assessed the ability of rivastigmine, a pseudo-irreversible cholinesterase
inhibitor, to improve behavioural and psychopathologic symptoms in AD. The
analysis included 34 patients present in the Germanarm of the international
study B303 who received and completed long-term treatment with rivastigmine in
the open-label study B305. Assessments of behaviour and psychopathological
symptoms were performed using the behavioural component of the Clinicians
Interview Based Impression of Change Plus (CIBIC-Plus). Results show that
long-term treatment with rivastigmine can slow the progression of behavioural
and psychopathological symptoms of AD. Behavioural symptoms showing
stabilisation included aggressiveness, activity disturbances, hallucinations
and paranoid features. Results also suggest that patients treated earlier with
rivastigmine may attain a greater benefit compared with patients whose
treatment is delayed 6 months. Further studies examining the effects of
rivastigmine on behavioural disturbances in AD are therefore warranted.
