Editorials

Drug treatments for Alzheimer's disease

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7082.693 (Published 08 March 1997) Cite this as: BMJ 1997;314:693

Raise clinical and ethical problems

  1. Cornelius A Kelly, Consultant senior lecturera,
  2. Richard J Harvey, Clinical research fellowb,
  3. Harry Cayton, Executive directorc
  1. a Mental Health Care For Older People, Department of Psychological Medicine, St Bartholomew's Hospital, Homerton Hospital, London E9 6SR
  2. b Dementia Research Group, National Hospital For Neurology and Neurosurgery, London WC1N 3BG
  3. c Alzheimer's Disease Society, London SW1 1PH

    Since early January a new treatment for Alzheimer's disease-the acetylcholinesterase inhibitor donepezil-has been available in the United States1 and last week was licensed in the UK. This and possibly other similar compounds will be introduced in the UK and other European countries shortly. Donepezil is the first drug to be licensed in the UK for Alzheimer's disease, and, while its benefits still appear modest, it is easily administered and its side effect profile appears favourable.2 The availability of such drugs does, however, raise clinical and ethical issues.

    In 30 week clinical trials a range of cholinesterase inhibitors have been shown to have broadly similar efficacy.2 3 These trials, designed to evaluate symptomatic treatment for Alzheimer's disease, have used two outcome measures: a sensitive measure of cognitive function (ADAS-Cog5) and a global measure of change rated by a clinician independent of the study and blind to all other measures (CIBIC6). Results, on average, have been a …

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