Papers

Efficacy of tacrine and lecithin in mild to moderate Alzheimer's disease: double blind trial

University of Sydney, Department of Geriatric Medicine, Repatriation General Hospital, Concord 2139, Australia National Health and Medical Research Council Social Psychiatry Research Unit, Australian National University, Canberra 0200, Australia Correspondence and requests for reprints to: Professor Broe.

Abstract

Objective : To assess the efficacy of tacrine and lecithin in treating Alzheimer's disease over nine months.
Design : Double blind randomised controlled trial.
Setting : Outpatients clinic of university department of geriatric medicine.
Subjects : 53 subjects (26 women, 27 men) with probable Alzheimer's disease. 41 completed the dose finding phase and were randomised to treatment. 32 (14 tacrine, 18 placebo) completed nine months' treatment.
Interventions : Lecithin and tacrine or lecithin and placebo for 36 weeks.
Main outcome measures : Scores on neuropsychological tests sensitive to deficits in the cholinergic system; mini-mental state score; behaviour change; mood; functional state; and stress in carers. Results - The tacrine and placebo groups were similar except that the tacrine group had a longer duration of disease (mean 5.4 v 2.5 years in placebo group; P=0.003). Only 17 of the 32 patients could tolerate the maximum dose of tacrine (100 mg). No significant difference was found between the groups for any of the tests after nine months' treatment except for the digit backwards test, which is insensitive to cholinergic deficit. Analysis of subjects taking the maximum dose of tacrine and of subjects with mild dementia also found no differences.
Conclusions : Tacrine produces no clinically relevant improvement over 36 weeks at the doses tolerated by these patients.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Qaseem, A., Snow, V., Cross, J. T. Jr., Forciea, M. A., Hopkins, R. Jr., Shekelle, P., Adelman, A., Mehr, D., Schellhase, K., Campos-Outcalt, D., Santaguida, P., Owens, D. K., the Joint American College of Physicians/American, (2008). Current Pharmacologic Treatment of Dementia: A Clinical Practice Guideline from the American College of Physicians and the American Academy of Family Physicians. ANN INTERN MED 148: 370-378 [Abstract] [Full text]  
• Raina, P., Santaguida, P., Ismaila, A., Patterson, C., Cowan, D., Levine, M., Booker, L., Oremus, M. (2008). Effectiveness of Cholinesterase Inhibitors and Memantine for Treating Dementia: Evidence Review for a Clinical Practice Guideline. ANN INTERN MED 148: 379-397 [Abstract] [Full text]  
• Simard, M., van Reekum, R. (2004). The Acetylcholinesterase Inhibitors for Treatment of Cognitive and Behavioral Symptoms in Dementia With Lewy Bodies. J. Neuropsychiatry Clin. Neurosi. 16: 409-425 [Abstract] [Full text]  
• Di Angelantonio, S., Costa, V., Carloni, P., Messori, L., Nistri, A. (2002). A Novel Class of Peptides with Facilitating Action on Neuronal Nicotinic Receptors of Rat Chromaffin Cells in Vitro: Functional and Molecular Dynamics Studies. Mol. Pharmacol. 61: 43-54 [Abstract] [Full text]  
• Qizilbash, N., Whitehead, A., Higgins, J., Wilcock, G., Schneider, L., Farlow, M., for the Dementia Trialists' Collaboration, (1998). Cholinesterase Inhibition for Alzheimer Disease: A Meta-analysis of the Tacrine Trials. JAMA 280: 1777-1782 [Abstract] [Full text]  
• WENGEL, S. P., ROCCAFORTE, W. H., BURKE, W. J., BAYER, B. L., MCNEILLY, D. P., KNOP, D. (1998). Behavioral Complications Associated With Donepezil. Am. J. Psychiatry 155: 1626k-1626 [Full text]  
• Eccles, M., Clarke, J., Livingston, M., Freemantle, N., Mason, J. (1998). North of England evidence based guidelines development project: guideline for the primary care management of dementia. BMJ 317: 802-808 [Full text]  
• Prentice, N., Van Beck, M., Dougall, N. J., Moffoot, A. P. R., O'Carroll, R. E., Goodwin, G. M., Ebmeier, K. P. (1996). A double-blind, placebo-controlled study of tacrine in patients with Alzheimer's disease using SPET. J Psychopharmacol 10: 175-181 [Abstract]  
• Pendlebury, W W, Solomon, P R, Levy, R, Roberts, C, Makela, P, Ford, J, Truman, C, Wilcock, G K, Broe, G A, Creasey, H, Maltby, N, Grayson, D A (1994). Tacrine and lecithin in Alzheimer's disease Tacrine is safe and effective. BMJ 308: 1506-1507 [Full text]  
• (1994). TACRINE AND ALZHEIMER'S: THERE'S STILL MORE TO LEARN. JWatch General 1994: 5-5 [Full text]  
• Byrne, E, Arie, T (1994). Tetrahydroaminoacridine and Alzheimer's disease. BMJ 308: 868-869 [Full text]