Apathy in Alzheimer's disease: any effective treatment?
Raffaele Rea1, Anna Carotenuto1, Angiola M Fasanaro2
1Centro di Ricerche Cliniche, Telemedicina e Telefarmacia, Università di Camerino, 62032 Camerino, Italy ; Unità Complessa Neurologia, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, 80131 Naples, Italy.
Objective:
This review has evaluated the effectiveness of pharmacological treatment of apathy in patients with Alzheimer's disease (AD).
Methods:
A systematic literature search was conducted on published clinical trials assessing the effects of pharmacological treatment on apathy in AD over the last 10 years.
Results:
Fourteen studies considered of good quality were included in the analysis (4 randomized controlled trials, 9 open-label studies, and 1 retrospective analysis). Cholinesterase inhibitors were investigated in 9 studies, monoaminergic compounds such as methylphenidate and modafinil in two trials and one trial, respectively, and Ginkgo biloba (EGb 761 extract) and citalopram in one study each. Cholinesterase inhibitors did not show statistical significant effect in 1 RCT study but were associated to improvement in 3 open-label studies. Methylphenidate elicited a small but significant activity accompanied by relevant side effects such as high blood pressure, cough, and osteoarticular pain. EGb 761 was well tolerated and countered apathy. Other treatments induced modest improvements or were ineffective.
Conclusions:
Apathy treatment remains a challenge and there is no evident advantage of any specific pharmacotherapy tested so far. The development of controlled studies according to updated guidelines for the diagnosis of apathy in patients with AD is desirable.
More Related Videos
08:01Intracerebroventricular Injection of Amyloid-β Peptides in Normal Mice to Acutely Induce Alzheimer-like Cognitive Deficits
Published on: March 16, 2016
09:45Motor and Hippocampal Dependent Spatial Learning and Reference Memory Assessment in a Transgenic Rat Model of Alzheimer's Disease with Stroke
Published on: March 22, 2016
Related Concept Videos
Alzheimer's Disease: Treatment
Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
Parkinson's Disease: Treatment
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
Alzheimer Disease ll: Pathophysiology
Alzheimer Disease l: Introduction
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
