1. Treatment of Dementia with Lewy Bodies and Parkinson's Disease Dementia.
- Author
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Ballard, Clive, Kahn, Zunera, and Corbett, Anne
- Subjects
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PARKINSON'S disease treatment , *DOPA , *AMANTADINE , *ANTIDEPRESSANTS , *ANTIPSYCHOTIC agents , *CHOLINESTERASE inhibitors , *DEMENTIA , *LEWY body dementia , *DONEPEZIL - Abstract
Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) account for 10-15% of late onset dementias. Key treatment targets include cognitive and functional impairments, neuropsychiatric symptoms including intense and persistent visual hallucinations, and parkinsonism. Six-month, placebo-controlled randomized controlled trials (RCTs) of the cholinesterase inhibitor rivastigmine have indicated modest but significant benefits in cogni- tion, function, global outcome and neuropsychiatric symptoms in both PDD and DLB. The evidence base for other cholinesterase inhibitors from RCTs is inconclusive. More recent RCTs with memantine in PDD/DLB patients indicate a benefit with regard to global outcome, with some suggestion of a specific benefit with respect to sleep disturbance. Given the risk of severe anti- psychotic sensitivity reactions, antipsychotics should be avoided. A significant proportion of PDD/DLB patients are responsive to levodopa, but care needs to be taken with anti-parkinsonian treatments because of their potential pro- pensity to exacerbate neuropsychiatric symptoms, particularly hallucinations. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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