Drug Evaluation

Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, Saint Louis, MI 63104, USA

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Binu Chakkamparambil

*Author for correspondence:

E-mail Address: binusuraj@gmail.com

https://orcid.org/0000-0002-8571-1420

Psychiatry, Mercy Clinic East Communities, Washington, MI 63090, USA

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George T Grossberg

Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, Saint Louis, MI 63104, USA

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Published Online:17 Nov 2020https://doi.org/10.2217/nmt-2020-0052

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Abstract

Dementia is the major cause of mortality and morbidity in older adults, with Alzheimer's disease (AD) being the most common cause. AD has a significant impact on economic and psychosocial status. Cholinesterase inhibitors (ChEIs) are currently the mainstay in the management of AD. Rivastigmine is the only ChEI that inhibits both acetylcholinesterase and butyrylcholinesterase enzymes in the brain. This dual inhibition makes it potentially more effective for AD patients. Its availability as both a transdermal formulation and oral capsule, may improve adherence rates and care giver satisfaction compared with other ChEIs. To date, the data from randomized clinical trials and post marketing observational studies have shown evidence for an impact on cognitive functions in AD with good safety and tolerability.

Lay abstract

Dementia is the major cause of death and disability in older adults, with Alzheimer's disease being the most common cause. Cholinesterase inhibitors (ChEIs) are the class of drugs that are used currently for the medical management of dementia. Among them, rivastigmine is the only ChEIs that inhibits certain enzymes in the brain. This inhibition makes the drug more effective for the patients. As this drug is also available as a skin patch, it makes the drug easier to administer and improves patient adherence to it. To date, the data from randomized clinical trials and post marketing observational studies have shown evidence for an impact in patient's cognitive abilities with good safety and minimal side effects. These data are summarized in this article.

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 11, No. 1

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History

Received 20 September 2020

Accepted 3 November 2020

Published online 17 November 2020

Published in print February 2021

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Keywords

Author contributions

Is in the order of authorship. GT Grossberg – mentor for all the authors who finalized the manuscript

Financial & competing interests disclosure

GT Grossberg is a consultant for Acadia, Alkahest, Allergan, Avanir, Biogen, Bioxcel, Genentech, Karuna, Lundbeck, Novartis, Otsuka, Roche, Takeda. He has received research support from NIA, is on the safety monitoring committee of EryDel, Newron, Anavex and on the data monitoring committee of ITI Therapeutics. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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Evaluation of rivastigmine in Alzheimer's disease

Abstract

Lay abstract

References