Preliminary Findings: Behavioral Worsening on Donepezil in Patients With Frontotemporal Dementia

Mendez, Mario F.; Shapira, Jill; McMurtray, Aaron; Licht, Eliot A.

doi:10.1097/01.jgp.0000231744.69631.33

Cited by 240 publications

(136 citation statements)

References 9 publications

Supporting

Mentioning

129

Contrasting

Unclassified

Order By: Relevance

“…119 For the management of cognitive symptoms related to FTD, several open label studies have demonstrated benefit in patients who were treated with NMDA antagonist (memantine) with doses up to 20mg/day. 120 In an open label study of 16 121 However a recent RCT of 81 patients did not demonstrate a clear benefit with NMDA antagonist (memantine). 122 The choice of acetylcholinesterase inhibitors should be based upon factors such as experience of the clinician, tolerance to side effects, ease of use, and the clinical profile of the individual to be treated.…”

Section: Frontotemporal Dementiamentioning

confidence: 99%

Systematic review of recent dementia practice guidelines

2014

View full text Add to dashboard Cite

Level Type of Evidence + +High quality meta-analyses, systematic reviews of randomised controlled trials (RCTs), or RCTs with a very low risk of bias. +Well conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of bias. -Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of bias + +High quality systematic reviews of case control or cohort studies. High quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2 + Well conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal -Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3Non-analytic studies, e.g. case reports, case series 4 Expert opinion Levels of evidence and grades of recommendation Statement of IntentThese guidelines are not intended to serve as a standard of medical care. Standards of medical care are determined on the basis of all clinical data available for an individual case and are subject to change as scientific knowledge advances and patterns of care evolve.The contents of this publication are guidelines to clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not ensure a successful outcome in every case. These guidelines should neither be construed as including all proper methods of care, nor exclude other acceptable methods of care. Each physician is ultimately responsible for the management of his/her unique patient, in the light of the clinical data presented by the patient and the diagnostic and treatment options available. ForewordDementia represents a major public health concern in Singapore and worldwide. Being the most prevalent neurodegenerative disease, dementia is expected to affect 55,000 patients in Singapore by the year 2020. The commonest cause of dementia is Alzheimer's disease with vascular dementia being the next most important cause. Right from the stage of mild dementia up to the stages of severe dementia, this condition poses a significant health and socio-economic burden to patients, caregivers and the nation as a whole. Early diagnosis will allow appropriate use of pharmacological and non-pharmacological management. Along with disease stabilization, efforts to address caregiver burden, patient safety and medico legal concerns should form the principles of management. Clear practise guidelines will allow holistic and optimal care in dementia.I am pleased to present the revised clinical practise guidelines for dementia. In this regard the workgroup has performed a thorough review of the existing literature to recommend both pharmacological and nonpharmacological aspects of management for patients ranging from mild cognitive impairment to severe dementia. This revised guidelines also highlights issues related to the management of mild cognitive impairment, young onset dementia and e...

show abstract

Section: Frontotemporal Dementiamentioning

confidence: 99%

Systematic review of recent dementia practice guidelines

2014

View full text Add to dashboard Cite

show abstract

“…27,29,30,32 Four quality B studies noted behavioral improvement without significant results, 12,28,34,36 two studies did not observe any significant behavioral change, 26,36 one study described behavioral worsening 33 and one study did not assess this aspect. 31 On the other hand, there were conflicting results from the studies that focused on the efficacy of treatment for cognitive impairment.…”

Section: Resultsmentioning

confidence: 99%

“…35 36 Two B studies did not evaluate cognitive functions. 12,33 The quality C studies showed a significant improvement in behavior with Selegiline. 37 Another seven studies noted improvement in behavior although not statistically significant.…”

Section: Resultsmentioning

confidence: 99%

“…49,50 FTLD is definitely not a hypocholinergic dementia. 30 This might explain why anticholinesterasics did not have significant therapeutic action in three studies 25,33,51 although one quality B study found significantly improved behavior 30 and one quality A study found cognitive improvement in FTLD. 22 Idazoxan is an alfa-2-adrenergic antagonist which can modulate noradrenaline function in the frontal lobe.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacological treatment of frontotemporal lobar degeneration: systematic review

Portugal

Marinho

Laks

2011

Rev. Bras. Psiquiatr.

View full text Add to dashboard Cite

Objective: To identify the therapeutic options available for treatment of cognitive and behavioral symptoms in frontotemporal lobar degeneration. Method: Systematic review using the descriptors "frontotemporal lobar degeneration" OR "frontotemporal dementia" OR "fronto-temporal dementia" OR "fronto-temporal degeneration" OR "Pick's disease" OR "Pick's atrophy" OR "semantic dementia" OR "progressive aphasia" AND "pharmacotherapy" OR "treatment" OR "efficacy" OR "effects" OR "management" was performed in the Medline and Lilacs databases. Selection criteria: Quality A -randomized clinical trials. Quality Bopen studies or reports of six or more cases. Quality C -reports of five or fewer cases. Two reviewers independently assessed the clinical studies. Information collected included diagnostic criteria used, sample size, duration, efficacy and tolerability measures used and results obtained. Results: From the 532 studies found, 29 complied with the inclusion criteria. All studies worked with a small sample, had short duration of treatment and used non-uniform measures in evaluating efficacy and tolerability. Studies showed disparate results with respect to behavior and cognition. Conclusion: There is still little, and poor, evidence available for treatment of frontotemporal lobar degeneration and studies with better methodological background are needed. Descriptors IntroductionThe clinical syndromes related to frontotemporal lobar degeneration (FTLD) are the second most common cause of pre-senile primary dementia. 1 A recent Brazilian epidemiological study found a dementia prevalence of 7.1% in individuals over

show abstract

“…For example, neuroleptic sensitivity is more common with DLB which treating clinicians must be mindful of when managing psychosis [13]. Furthermore while acetylcholinesterase inhibitors are effective in AD and DLB [17], they may exacerbate symptoms in FTD [18]. Hence the previously reported increase in psychiatric disorders in presenting NESB patients [2] which could lead to under-diagnosis of non-AD dementias warrants further study.…”

Section: Clinical and Social Implicationsmentioning

confidence: 99%