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Two cases of Alzheimer's disease showing deterioration of behavioral and psychological symptoms of dementia induced by switching from rivastigmine to donepezil

Authors Kimura T, Takamatsu J

Received 4 September 2012

Accepted for publication 15 October 2012

Published 28 December 2012 Volume 2013:9 Pages 49—53

DOI https://doi.org/10.2147/NDT.S37688

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Takemi Kimura, Junichi Takamatsu

Division of Clinical Research, National Hospital Organization Kikuchi Hospital, Koshi, Kumamoto, Japan

Abstract: Rivastigmine, galantamine, and memantine, in addition to donepezil, which has been on the market over 10 years, have been available for the treatment of Alzheimer's disease (AD) since 2011 in Japan, leading a new stage in the medical treatment of AD. We studied two AD patients showing sudden deterioration of behavioral and psychological symptoms of dementia (BPSD) associated with switching from rivastigmine to donepezil after the clinical trial of rivastigmine. In the patients, rivastigmine seemed to be more beneficial than donepezil for the control of BPSD. Although It was not obvious whether their different responses to the two cholinesterase inhibitors were due to the different pharmacological profiles, ie, the presence of inhibition of butyrylcholinesterase in rivastigmine, a particular cholinesterase inhibitor might be more effective in particular AD cases. Further investigations are needed to confirm the difference, and to identify the measures for selecting the most appropriate medication for each AD patient.

Keywords: rivastigmine, donepezil, cholinesterase inhibitors, switching, behavioral and psychological symptoms of dementia, neuropsychiatric inventory, Japanese, Alzheimer's disease

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