Abstract:
BACKGROUND:When otherwise unexplained, syncope in patients with Alzheimer's disease may be attributed to bradycardia caused by cholinesterase inhibitors. We studied prospectively the clinical events and cardiovascular changes occurring during treatment with donepezil in patients with Alzheimer's disease. METHODS:Consecutive patients presenting with mild-to-moderate Alzheimer's disease were included in the study. Their clinical characteristics, blood pressure, heart rate and electrocardiogram were recorded before (baseline) and during treatment with donepezil. The drug was administered at a dosage of 5 mg/day for 1 month and 10 mg/day for the following 7 months, as tolerated. We compared the baseline observations with those made at 1, 2 and 8 months of donepezil treatment. We also examined the effects of negatively chronotropic or dromotropic drugs concomitantly administered with donepezil. RESULTS:Thirty patients were included in the study, of whom 43% were taking negatively chronotropic or dromotropic drugs. The first month of therapy (donepezil 5 mg/day) was completed by 26 patients. During the 7-month high-dosage phase (10 mg/day), four patients dropped out of the study; thus, 22 patients completed the full 8 months of the study. The mean heart rate was 66 +/- 8 beats/min at baseline in the overall study population. This decreased significantly to 62 +/- 9, 61 +/- 7 and 62 +/- 8 beats/min at the 1, 2 and 8 month timepoints, respectively (all p = 0.002 vs baseline). Among patients not receiving negatively chronotropic or dromotropic drugs, heart rate decreased significantly over the course of the study (from 67 +/- 8 beats/min at baseline to 62 +/- 8 beats/min at 1 month, 62 +/- 7 beats/min at 2 months and 62 +/- 8 beats/min at 8 months [all p = 0.005 vs baseline]). There was no significant change in heart rate in patients who were receiving negatively chronotropic or dromotropic drugs. The PR interval increased over the course of the study in all patient groups, but these changes were only statistically significant in the group of patients who were not taking negatively chronotropic or dromotropic drugs (155 +/- 23ms at baseline vs 158 +/- 21, 160 +/- 22 and 163 +/- 24ms at the 1, 2 and 8 month timepoints; all p = 0.02 vs baseline). One patient developed syncope due to orthostatic hypotension; there were no cases of bradycardia-induced syncope. Gastrointestinal manifestations were reported in ten of the study patients. Abdominal pain and vomiting were the reasons for study termination in five of the eight patients who did not complete the trial. CONCLUSION:A donepezil-induced decrease in heart rate and increase in PR interval were observed only in patients with Alzheimer's disease who were not treated with negatively chronotropic or dromotropic drugs. These changes were not associated with bradycardia-induced syncope.
journal_name
CNS Drugsjournal_title
CNS drugsauthors
Bordier P,Garrigue S,Lanusse S,Margaine J,Robert F,Gencel L,Lafitte Adoi
10.2165/00023210-200620050-00005subject
Has Abstractpub_date
2006-01-01 00:00:00pages
411-7issue
5eissn
1172-7047issn
1179-1934pii
2055journal_volume
20pub_type
临床试验,杂志文章相关文献
CNS DRUGS文献大全abstract::Epileptic encephalopathy is defined as a condition where the epileptic activity itself may contribute to the severe neurological and cognitive impairment seen, over and above that which would be expected from the underlying pathology alone. The epilepsy syndromes at high risk of this are a disparate group of condition...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-013-0041-6
更新日期:2013-03-01 00:00:00
abstract::Social anxiety disorder (SAD) is a prevalent and disabling disorder associated with significant co-morbidity. An increased awareness of SAD over the past two decades has given impetus to advances in the pharmacotherapeutic and psychotherapeutic treatment options for this disorder. On the basis of consistent data from ...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200519050-00002
更新日期:2005-01-01 00:00:00
abstract::The circadian rhythm of pineal melatonin secretion, which is controlled by the suprachiasmatic nucleus (SCN), is reflective of mechanisms that are involved in the control of the sleep/wake cycle. Melatonin can influence sleep-promoting and sleep/wake rhythm-regulating actions through the specific activation of MT(1) (...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200721120-00004
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:There is growing epidemiological evidence that opioids may increase the risk of unintentional injuries and it is plausible that the time of initiation is most critical in that respect. Studies on fall-related injuries remain few, limited and mostly focused on specific groups of elderly patients. OBJECTIVE:T...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.1007/s40263-013-0038-1
更新日期:2013-02-01 00:00:00
abstract::Alzheimer's disease (AD) is frequently associated with neuropsychiatric symptoms (NPS) such as agitation and aggression, especially in the moderate to severe stages of the illness. The limited efficacy and high-risk profiles of current pharmacotherapies for the management of agitation and aggression in AD have driven ...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-015-0270-y
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To collect descriptive data on the treatment of Alzheimer's disease with galantamine under naturalistic conditions. STUDY DESIGN:This was a prospective, open-label, observational study. PATIENTS:Subjects (n = 345) with mild to moderately severe dementia of the Alzheimer's type were recruited from 48 hospita...
journal_title:CNS drugs
pub_type: 临床试验,杂志文章
doi:10.2165/00023210-200620110-00006
更新日期:2006-01-01 00:00:00
abstract::Biopharmaceuticals can induce antibodies, which interact with and neutralize the therapeutic effect of such drugs and are therefore termed neutralizing antibodies (NAbs). In the treatment of multiple sclerosis, NAbs against interferon (IFN)-beta and natalizumab have been recognized. The prevalence of NAbs against diff...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200923050-00003
更新日期:2009-01-01 00:00:00
abstract::A number of news items and case reports describing complex behaviours (e.g. sleep driving, sleep cooking, sleep eating, sleep conversations, sleep sex) associated with the use of hypnosedative medications have recently received considerable attention. Regulatory agencies examining these reports have subsequently issue...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/0023210-200822120-00005
更新日期:2008-01-01 00:00:00
abstract::Frontotemporal lobar degeneration (FTLD) describes a spectrum of clinically, pathologically and genetically heterogeneous neurodegenerative disorders of unknown aetiology. FTLD spectrum disorders collectively represent a leading cause of early-onset dementia, with most cases presenting between 45 and 64 years of age. ...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/11640070-000000000-00000
更新日期:2012-10-01 00:00:00
abstract::Postherpetic neuralgia, which occurs most typically in older persons, is one of the most common and serious complications of herpes zoster (or shingles). It is a chronic neuropathic pain syndrome and remains one of the most difficult pain disorders to treat. Known beneficial agents include antidepressants, antiepilept...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200317110-00001
更新日期:2003-01-01 00:00:00
abstract::The common strategy to treat a migraine attack as soon as it begins, made for classical acute antimigraine treatments such as ergotamine and analgesics, has not been transposed to the triptans. The recommendation to delay triptan intake until headache intensity is at least moderate is merely a habit generated by the p...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.2165/00023210-200115080-00001
更新日期:2001-01-01 00:00:00
abstract::Spinal cord injury (SCI) has a number of severe and disabling consequences, including chronic pain, and around 40% of patients develop persistent neuropathic pain. Pain following SCI has a detrimental impact on the patient's quality of life and is a major specific healthcare problem in its own right. Thus far, there i...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200822060-00002
更新日期:2008-01-01 00:00:00
abstract::Symptoms of anxiety and depression often appear together in patients, either as 2 discrete disorders, such as major depressive disorder and panic disorder, or as a combination of symptoms not meeting criteria for specific disorders. The social, economic, occupational and medical costs of such comorbid anxiety and depr...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.2165/00023210-199809040-00003
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:There are few data about the cost effectiveness of prophylactic medications for migraine. Clinical trials have shown several preventive agents to be useful in reducing the frequency of migraine attack while having tolerable side effects. OBJECTIVE:To compare the cost effectiveness of adding preventive treat...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.2165/11531180-000000000-00000
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Although levodopa is considered the most effective pharmacotherapy for motor symptoms of Parkinson's disease (PD), chronic use is associated with motor complications, including fluctuating response and unpredictable, involuntary movements called dyskinesia. ADS-5102 (amantadine) extended-release (ER) capsule...
journal_title:CNS drugs
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40263-018-0498-4
更新日期:2018-04-01 00:00:00
abstract::Treatment-resistant depression (TRD) presents major challenges for both patients and clinicians. There is no universally accepted definition of TRD, but results from the US National Institute of Mental Health's (NIMH) STAR*D (Sequenced Treatment Alternatives to Relieve Depression) programme indicate that after the fai...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/11530280-000000000-00000
更新日期:2010-02-01 00:00:00
abstract::The coronavirus 2019 (COVID-19) pandemic is expected to linger. Decisions regarding initiation or continuation of disease-modifying therapy for multiple sclerosis have to consider the potential relevance to the pandemic. Understanding the mechanism of action and the possible idiosyncratic effects of each therapeutic a...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-020-00756-y
更新日期:2020-09-01 00:00:00
abstract::The almost ubiquitous sleep disturbances in patients with depression commonly, but not always, subside with the remission of depression. Evidence linking insomnia with the risk of relapses in recurrent depression, as well as suicide, makes optimization of the treatment of insomnia associated with depression a priority...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200923040-00004
更新日期:2009-01-01 00:00:00
abstract::The anilidopiperidine opioid remifentanil has pharmacodynamic properties similar to all opioids; however, its pharmacokinetic characteristics are unique. Favourable pharmacokinetic properties, minimally altered by extremes of age or renal or hepatic dysfunction, enable easy titration and rapid dissipation of clinical ...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200418150-00004
更新日期:2004-01-01 00:00:00
abstract::Varenicline (Chantix, Champix) is an orally administered alpha4beta2 nicotinic acetylcholine receptor partial agonist that is indicated as an aid to smoking cessation. Varenicline was an effective aid to smoking cessation and was generally well tolerated in clinical trials, although more data are needed regarding the ...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/11204710-000000000-00000
更新日期:2010-09-01 00:00:00
abstract::Glutamatergic, noradrenergic, serotonergic, and cholinergic systems play a critical role in the basal ganglia circuitry. Targeting these non-dopaminergic receptors remains a focus of ongoing research to improve Parkinson's disease (PD) motor symptoms, without the potential side effects of dopamine replacement therapy....
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-020-00754-0
更新日期:2020-10-01 00:00:00
abstract::Schizophrenia is a long-term psychiatric disorder that impacts important mental functions and requires indefinite treatment, as well as psychosocial and economic support. The introduction of chlorpromazine, the first antipsychotic, and the subsequent development of a long list of similar dopamine-blocking antipsychoti...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-018-0588-3
更新日期:2019-01-01 00:00:00
abstract::The pervasive and devastating nature of substance use disorders underlies the need for the continued development of novel pharmacotherapies. We now know that glia play a much greater role in neuronal processes than once believed. The various types of glial cells (e.g., astrocytes, microglial, oligodendrocytes) partic...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.1007/s40263-020-00721-9
更新日期:2020-07-01 00:00:00
abstract::Anticonvulsant hypersensitivity syndrome (AHS) is a rare, but potentially fatal, adverse reaction that occurs in patients, including children, who are treated with anticonvulsants. During metabolism of the anticonvulsant, toxic arene-oxide compounds are produced. AHS is associated with both cutaneous and systemic symp...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200216030-00006
更新日期:2002-01-01 00:00:00
abstract::The development of an intervention to slow or halt disease progression remains the greatest unmet therapeutic need in Parkinson's disease. Given the number of failures of various novel interventions in disease-modifying clinical trials in combination with the ever-increasing costs and lengthy processes for drug develo...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-018-0548-y
更新日期:2018-08-01 00:00:00
abstract::How a woman responds to sexual cues is highly dependent on a number of distinct, yet related, factors. Researchers have attempted to explain the female sexual response for decades, but no single model reigns supreme. Proper female sexual function relies on the interplay of somatic, psychosocial and neurobiological fac...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-015-0288-1
更新日期:2015-11-01 00:00:00
abstract::Numerous in vitro and in vivo experimental animal studies have demonstrated that gangliosides, particularly GMI ganglioside (siagoside), may stimulate or accelerate the repair of peripheral and central nervous system neurons after various types of damage. Clinical studies of GMl in peripheral neuropathies and stroke, ...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.2165/00023210-199401030-00006
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:The molecules that provide access to activated T cells in the CNS, including chemokines, have been considered to be a crucial step in the pathogenesis of multiple sclerosis (MS). AIMS:In this study, we investigated serial serum chemokine levels in patients with relapsing-remitting MS over 1 year and the ass...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.2165/11595060-000000000-00000
更新日期:2011-11-01 00:00:00
abstract::Clinically relevant movement disorders are identified in 3% of patients with HIV infection seen at tertiary referral centres. In the same setting, prospective follow-up shows that 50% of patients with AIDS develop tremor, parkinsonism or other extrapyramidal features. Hemiballism-hemichorea and tremor are the most com...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200216100-00002
更新日期:2002-01-01 00:00:00
abstract::Hashimoto's encephalopathy is a term used to describe an encephalopathy of presumed autoimmune origin characterised by high titres of antithyroid peroxidase antibodies. In a similar fashion to autoimmune thyroid disease, Hashimoto's encephalopathy is more common in women than in men. It has been reported in paediatric...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200721100-00002
更新日期:2007-01-01 00:00:00